Background: Combined injuries observed with first-time lateral patellar dislocation (LPD) of the knee, particularly significant soft tissue injury, can inform surgical intervention criteria.
Purpose: The purpose of this study was to compare MRI findings in LPD to surgical correlation concerning meniscal pathology as a guide for surgical management.
Study Design: Retrospective case series, Level of evidence, 4.
Anatomic variants of lower extremity musculature, such as the gastrocnemius, popliteus, and the plantaris have been well described in the literature. The impact of these anatomical variations on clinical outcomes depends on their proximity to and effects on adjacent anatomical structures, particularly in the context of planned surgical procedures in the region. While the presence of the accessory plantaris is rare, no previous cases have described it negatively affecting surgical outcomes to our knowledge.
View Article and Find Full Text PDFInjection drug use (IDU) is a risk factor for septic arthritis (SA) of native joints. Amid the opioid crisis, IDU rates have increased. This study assessed differences in pre-operative characteristics, microbial characteristics, and postoperative outcomes of 177 cases of SA treated operatively from 2015 to 2019 at 3 US hospitals, by self-reported IDU status.
View Article and Find Full Text PDFCongenital diaphragmatic hernias rarely present after 2 months of age and are typically diagnosed in the perinatal period. Moderate to severe diaphragmatic hernias present with respiratory symptoms, while late-onset hernias have a more varied presentation, depending on the age and content of the hernia. Very rarely, such hernias are found on incidental imaging, in which surgical repair is frequently recommended.
View Article and Find Full Text PDFEmerging evidence implicates an interplay among multiple organs such as brain, vasculature, gut and lung in the development of established pulmonary arterial hypertension (PAH). This has led us to propose that activated microglia mediated-enhanced sympathetic activation contributes to PAH pathophysiology. Since enhanced sympathetic activity is observed in human PAH and the gut is highly innervated by sympathetic nerves that regulate its physiological functions, we hypothesized that PAH would be associated with gut pathophysiology.
View Article and Find Full Text PDFTherapeutic advances for pulmonary hypertension (PH) have been incremental because of the focus on the pulmonary vasculature in PH pathology. Here, we evaluate the concept that PH is, rather, a systemic disorder involving interplay among multiorgan systems, including brain, gut, and lungs. Therefore, the objective of this study was to evaluate the hypothesis that PH is associated with a dysfunctional brain-gut-lung axis and that global overexpression of ACE2 (angiotensin-converting enzyme 2) rebalances this axis and protects against PH.
View Article and Find Full Text PDFCase: A 62-year-old man with no comorbidities presented with back and bilateral leg pain and progressive paraplegia that developed over a 1-week period. He had received 2 lumbar epidural steroid injections (LESIs) for lumbar stenosis 39 and 25 days before presentation. Workup revealed osteomyelitis of L4 and L5 with epidural abscesses.
View Article and Find Full Text PDFIntroduction: Opioid-related compartment syndrome (ORCS) is an understudied complication related to opioid overdose. We hypothesized that ORCS would be associated with worse clinical outcomes, including higher amputation rates, need for multiple surgical procedures, and rhabdomyolysis on admission, compared with nonopioid-related compartment syndrome (NORCS).
Methods: We used Current Procedural Terminology codes for fasciotomy as a proxy marker for cases of compartment syndrome treated at 1 health system from January 1, 2016, to December 21, 2018.
Background We have demonstrated that the antihypertensive effect of the angiotensin-converting enzyme inhibitor, captopril ( CAP ), is associated with beneficial effects on gut pathology. Coupled with the evidence that CAP exerts prolonged reduction in blood pressure ( BP ) after discontinuation of treatment, we investigate whether persistent beneficial actions of CAP are linked to alterations of gut microbiota and improvement of hypertension-induced gut pathology. Methods and Results Spontaneously hypertensive rats ( SHR ) and Wistar Kyoto rats were treated with CAP (250 mg/kg/day) for 4 weeks followed by withdrawal for 16 weeks.
View Article and Find Full Text PDFRationale: Increased microglial activation and neuroinflammation within autonomic brain regions have been implicated in sustained hypertension, and their inhibition by minocycline-an anti-inflammatory antibiotic-produces beneficial effects. These observations led us to propose a dysfunctional brain-gut communication hypothesis for hypertension. However, it has been difficult to reconcile whether an anti-inflammatory or antimicrobial action is the primary beneficial effect of minocycline in hypertension.
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