Opioid Use After Knee Arthroscopy.

PURPOSE: To quantify the use of 5 mg oxycodone by patients who have undergone knee arthroscopy. METHODS: Patients who underwent knee arthroscopy at 2 institutions between May 2018 and May 2019 were identified retrospectively. Patients were called and queried about the following metrics: total postoperative opioid consumption, preoperative opioid consumption (defined as within 3 months of surgery), smoking status, and history of depression. The total number of opioids prescribed and number of refills were determined according to each patient's chart. State databases were reviewed for additional opioid prescriptions. RESULTS: A total of 100 patients were included in this study. Patients were prescribed a median of 5 pills (range, 5 to 40). Median postoperative opioid consumption was 0 pills, with a mean of 1.9 pills (14.3 oral morphine equivalents) and a range of 0 to 25 pills of oxycodone 5 mg. Of the patients, 97% did not obtain refills, and 58% of the patients did not consume any opioids. Overall, 90% of all patients consumed ≤ 5 pills. CONCLUSIONS: Of the patients, 90% o consumed 5 or fewer opioid pills (oxycodone 5 mg) following knee arthroscopy, with more than half of the patients consuming 0 pills. As a result, we recommend that 5 oxycodone 5 mg pills serve as an objective guideline for opioid prescription following knee arthroscopy. LEVEL OF EVIDENCE: Level IV, retrospective case series.

Failure rate prediction of equipment: can Weibull distribution be applied to automated hematology analyzers?

Background Life cycle prediction measures, that provide information on the probability of failure of equipments, have been applied in electronic and mechanical engineering and for predicting the strength of dental implants. However, the same has not been utilized as yet in medical equipment such as hematology analyzers. Methods Failure data of five automated hematology analyzers (3-part differential) was collected over 14 consecutive months and a Weibull probability plot was made. The scale and shape parameters of this plot were used to predict failure probability distribution. This was then combined with various costs involved in remedial maintenance to get a cost analysis. Results The analyzers in their "useful life" period were found to suffer fewer actual and predicted failures compared to those in the "wear out" phase. Cost analysis showed a considerably higher per month cost of remedial maintenance of analyzers compared to the price of a comprehensive maintenance contract. Conclusions Our study demonstrates, for the first time, that Weibull distribution can be applied well to hematology analyzers for modeling of failure data and the resultant information is helpful in the cost analysis of maintenance to allow for prudent and informed decision making with regards to the mode of maintenance of analyzers.

Sclerosing polycystic adenosis: A rare tumor misdiagnosed as retention cyst on fine needle aspiration cytology.

Sclerosing polycystic adenosis (SPA) is a rare benign neoplasm of the salivary gland which resembles the fibrocystic disease of the breast clinically as well as morphologically. This entity has varied morphological presentation on fine needle aspiration. Only a few case reports and occasional case series are found in the literature describing its cytology. Here we are presenting a case of SPA in the parotid gland in a 13-year-old male patient who presented with a slow growing infra-auricular mass since one year without any other symptoms. Radiological investigation suggested a possibility of matted level II cervical lymph nodes. Fine needle aspiration of the same showed only crystalloids in a dirty background. Hence, a possibility of retention cyst was given and excision was advised. On histopathological examination, the mass was diagnosed as Sclerosing polycystic adenosis of the parotid gland. Since SPA is a rare entity with diverse morphological features, it is more likely to be misdiagnosed on cytology. Recognition of this benign entity is important since the differential diagnosis includes other more common benign and malignant salivary gland neoplasm particularly mucoepidermoid carcinoma and other tumors with cystic and oncocytic features. Repeat aspiration from multiple sites should be considered in cystic lesions of the salivary gland so that its varied cytological components can be yielded to help with the diagnosis. Diagn. Cytopathol. 2017;45:640-644. © 2017 Wiley Periodicals, Inc.

Reporting of adverse events and statistical details of efficacy estimates in randomized clinical trials of pain in temporomandibular disorders: Analgesic, Anesthetic, and Addiction Clinical Trial Translations, Innovations, Opportunities, and Networks systematic review.

BACKGROUND: Statistical methods and adverse events (that is, harms) data affect the accuracy of conclusions about the risk-to-benefit ratio of treatments for temporomandibular disorders (TMDs). The authors reviewed the quality of reporting in TMD clinical trials to highlight practices that are in need of improvement. TYPES OF STUDIES REVIEWED: The authors included articles published between 1969 and May 31, 2013, in which the investigators reported randomized clinical trials of TMD treatments with pain as a principal outcome variable. Investigators in trials of nonpharmacologic and noninvasive treatments were required to at least mask the participants and assessors; all others were required to be double masked. RESULTS: Ninety articles qualified for this review: 39 published between 1971 and 2005 (older articles) and 51 published between 2006 and 2013 (newer articles). Specification of primary outcome analyses, methods to accommodate missing data, and adverse event collection methods and rates were generally poor. In some cases, there was apparent improvement from the older to the newer cohort; however, reporting of these methodological details remained inadequate even in the newer articles. PRACTICAL IMPLICATIONS: This review is designed to alert authors, reviewers, editors, and readers of TMD clinical trials to these issues and improve reporting quality in the future.