When to Get Ear Tubes for My Child

December 6, 2010

Sabine Hesse, M.D.
Ear, Nose and Throat (ENT)

Broward Health

Drs. Janke and Naide Perform An Anterior Hip Replacement Using The hana® Table

November 10, 2010

Many individuals have joint pain that hampers everyday activities, either because of arthritis, a fracture or other conditions. If medications and use of aids such as a cane are not helpful, patients, after consultation with their doctor, may find relief from their pain with joint replacement surgery. The goal of joint replacement surgery is to relieve joint pain caused by damage to the cartilage or bone.

At North Broward Medical Center, Drs. Janke and Naide use what is called a hana® table. The hana® table is a specially designed surgical table that allows for hyperextension, adduction and external rotation of the hip to an extent not possible with conventional tables. While utilizing the table, surgeons are able to replace the hip without detachment of the muscles or tendons from the hip or thigh bones.

With the anterior approach, a small four-inch incision is made just below and to the outside of the groin. Two muscles are then pushed aside, giving the surgeons access to the hip socket to perform the replacement. No muscles at any time during the procedure are split or detached. For the patient, that results in a faster recovery, less pain, smaller incision, less blood loss and less scarring.

Click here to learn more and to see an actual video of these doctors perform the procedure live.

The Troubling Rise of ACL Injuries in Young Female Athletes

October 25, 2010

Dr. Erol Yoldas, Orthopedic Surgeon

Dr. Erol Yoldas, Orthopedic Surgeon

Tears of the anterior cruciate ligament (ACL) have been the scourge of male athletes for decades, causing everyone from star NFL quarterbacks to high school lacrosse players to miss entire seasons while devoting months to rehabilitation. Today, ACL tears are having an even more significant impact on young female athletes as more girls begin participating in sports at an early age.

Erol Yoldas, MD, orthopedic surgeon and fellowship-trained sports medicine specialist at Broward Health, has witnessed the shift firsthand. When Dr. Yoldas underwent training two decades ago, he witnessed many more ACL tears in male athletes than their female counterparts. Today, he sees four female patients for ACL tears at the Orthopedic Sports Medicine Center for every one male patient with the injury. Dr. Yoldas points to three risk factors to explain girls’ susceptibility to ACL tears.

• Girls use their muscles differently than males when jumping, landing and cutting in non-contact activities, and their reaction times seem to predispose them to ACL injury.

• Female anatomy, such as a wider pelvis, distributes force differently across the knee than in males and exposes the ACL to increased stress.

• Female hormones, which can change the elasticity and shape of the body, have sometimes been shown to affect the strength of the ACL.

“Preventing ACL tears in young female athletes involves re-educating them on how to jump and land,” says Dr. Yoldas. “They must learn how to avoid landing in a valgus position and instead do so with their kneecaps pointed forward. Re-education can certainly be addressed by a practice like the Orthopedic Sports Medicine Center, but it should most properly be covered by coaches and athletic trainers in preseason conditioning beginning in middle school.”

Watch Dr. Yoldas perform a LIVE ACL Repair on a young female athlete.

Improved Results From New Approach To Hip Repair

September 22, 2010

Dominic Carreira , M.D., Orthopedic SurgeonDominic Carreira, M.D.
Orthopedic Surgeon
Specializing in Hip Arthroscopy, Foot and Ankle

Read the story of a 33-year old female spin instructor who underwent advanced minimally invasive hip surgery. The patient, Tracey Anderson, damaged the cartilage in her hip, resulting in a labral tear. Anderson went through a minimally invasive surgery to remove the damaged cartilage, but the pain didn’t go away.

Dr. Carreira then decided to try a new approach, referred to as advanced hip arthroscopy. Within weeks of the procedure, Anderson was finally pain free and back in the gym. Read more

General Surgeons Play Big Role in Breast Cancer

September 2, 2010

Gary Lehr, MD
Medical Director of Surgical Cancer Services at Broward Health North Broward Medical Center

In our era of micro-management and super specialization, it is a common perception amongst many people that a “super” specialist needs to be involved with patient care when certain problems arise. This is frequently evident when a woman hears the words “you have breast cancer.” The management of a woman with breast cancer almost ALWAYS involves the participation of a surgeon, as well as medical oncologists and radiation oncologists. Some feel that a specialized “breast surgeon” or “surgical oncologist” is necessary for thorough care. However, although somewhat of a misnomer, General Surgeons are a highly trained group of surgical specialists with a wide range of knowledge and expertise, including the comprehensive management of patients with breast cancer. General Surgeons become quite familiar with all aspects of breast cancer care during their five/six year surgical residency. Breast cancer is one of the most common malignancies encountered in private practice by General Surgeons, particularly in South Florida.

General Surgeons usually become involved early on in the management process, either when a lump is discovered, or a mammogram or ultrasound has been determined to be abnormal. Initial biopsy, if indicated, can be done by the General Surgeon. Once a definitive diagnosis of breast cancer has been confirmed, surgical management by the General Surgeon is tailored to the specific patient’s individual circumstances. Options usually exist regarding the extent of resection of the tumor itself, depending on the size of the cancer, location in the breast, and size of the breast. Lumpectomy (removal of the tumor with a small margin of normal tissue), partial mastectomy (removal of a more generous portion of breast tissue, but still leaving the majority of the breast intact), and total mastectomy (removal of the entire breast) may all be viable options. If the cancer has been classified as “invasive”, then sentinel lymph node biopsy is also accomplished at the same surgical setting. This involves locating, and then removing, the first few lymph nodes, usually in the axilla (armpit), that drain the breast. If these are found to be normal on microscopic evaluation, then the rest of the lymph nodes should be normal as well, eliminating the need for a more extensive resection. This, in turn, reduces the likelihood of arm swelling (lymphedema) following surgery.

Subsequent care with medical oncologists or radiation oncologists depends on the eventual staging of the cancer. Sometimes, surgery is all that is required. The General Surgeon is quite familiar with the total care of a woman with breast cancer, and can make recommendations regarding the need for further care. In our practice, we have taken care of countless patients with both benign and malignant breast problems, and take pride in the thoroughness and comprehensive management we give to each patient.

Gary S. Lehr, M.D., FACS, Randy Kimmelman, D.O., Michael Mallis Jr., D.O., Camil Sader, M.D., FACS, and Ron Stricoff, M.D., FACS, are all Board Certified General Surgeons, with years of experience in the management of breast cancer.

Is It Ok To Give My Child Cold Medicines?

August 10, 2010

David Harrison, M.D.
Pediatrics, Broward Health Coral Springs Medical Center

Scarless Surgery (SILS)

July 20, 2010

Dr. Camil N. SaderCamil N. Sader, MD, FACS
General Surgeon
Broward Health North Broward Medical Center

A tiny single incision within the depth of the umbilicus is usually all that is required for this new technique. You may have heard of SILS, but it really is fast becoming the treatment of choice for patients undergoing laparoscopic surgery. Having had friends and family members who have undergone a SILSTM procedure, many patients are now asking for SILSTM by name. Performed within the same time it takes a traditional laparoscopic procedure, a single incision often means less pain, less incision related complications, faster return to daily activities, and a significant cosmetic difference. Many ER physicians are no longer relying on “reading” their patient’s scars to determine their surgical history.

Warning Signs of Childhood Asthma

June 25, 2010

Tatiana Pestana, M.D.
Pediatrics, Broward Health Coral Springs Medical Center


Runners Beware

June 10, 2010
Dr. Phillip Decubellis, DPM, PhD

Dr. Phillip Decubellis, DPM, PhD, Podiatry and Wound Care

RUNNING INJURIES
Summer is a great time to get back into your running routine or to ramp up you training and exercise for the coming summer months. But it’s always important to take it slowly and to train carefully with the advice of an expert to avoid running injuries.

Before you get started, no matter how fit you may be, it’s important to remember that stretching before and after a run is a great way to minimize injuries. Choosing proper footwear is very important and your podiatrist can help you choose the right shoe for your level of activity. Finally, you will want to work with the doctor to develop an effective training routine that allows your body (and more importantly, your feet) to adapt to a new level of exercise. But no matter how careful you are, you may end up with some common injuries such as those listed here.

Shin splints: Shin splints, which are painful and appear at the front and inside of the leg, are often caused by running on hard surfaces, over striding, muscle imbalance, or overuse. Shin splints can also be related to the shape and structure of your feet. Treatment includes rest, stretching, changing your running technique, and rebalancing foot mechanics with the use of an orthotics device in the shoe. Physical therapy can also be helpful. If you begin to feel this type of pain, slow down, take shorter strides, and see a podiatrist at your first opportunity.

Stress fractures: A stress fracture is a tiny or incomplete crack in a bone that is often caused by overuse. Stress fractures occur most frequently in the foot and ankle, so your podiatrist is well trained to diagnose and treat this problem. Signs of a stress fracture are pain that increases with activity and decreases with rest, pain that increases over time or pain that persists even at rest. Often a stress fracture will result in swelling and a spot that feels tender to the touch.

Prompt diagnosis and treatment of a stress fracture can often prevent further injury. Your podiatrist can determine your best treatment with x-ray and a physical exam. Many stress fractures can be treated with rest, ice and over-the-counter pain relievers. For most people, an appropriate period of rest will be sufficient for the bone to heal, but like all fractures, the bone can take up to 8 to10 weeks to heal completely. In other cases, your podiatrist may need to immobilize the affected bone with a cast, cast boot, fracture shoe, or a splint. Surgical intervention may be suggested if other, more conservative treatments are not effective.

Blisters and nail problems: Runners often have blisters and nail problems but with a little maintenance and care, they can be avoided or minimized so that they don’t limit your ability to keep up your training routine. Blisters are caused by skin friction. Don’t pop them. Apply moleskin or an adhesive bandage over a blister, and leave it on until it falls off naturally in the bath or shower. Keep your feet dry and always wear socks as a cushion between your feet and shoes. If a blister breaks on its own, wash the area, apply an antiseptic, and cover with a sterile bandage.

Ingrown nails are nails whose corners or sides dig painfully into the skin, often causing infection. They are frequently caused by improper nail trimming but also by shoe pressure, injury, or poor foot structure. Runners are particularly susceptible to nail problems, and long-distance runners often lose some of their toenails entirely while they are training. If an ingrown portion of the nail is painful or infected, your podiatrist can remove the affected portion to allow for healing. It is possible to permanently remove the offending portion of the nail to prevent occurrence. Just a few of the problems runners run into. If you have any foot or leg problems, just email me at info@podiatristfl.com and I will do my best to help you.

ADD vs. ADHD

May 26, 2010

Mariana Martinasevic, M.D.
Child and Adolescent Psychiatry
Broward Health


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