Skeletal Manifestations of Gaucher's Disease: A Case Report and Literature Review.

Gaucher's disease (GD) is a lysosomal storage disorder characterized by the storage of glucosylceramide in macrophages ("Gaucher cells"), mainly in the reticuloendothelial system. GD type 1 (GD1) is the most common phenotype that usually manifests with hepatosplenomegaly, cytopenias, and bone involvement. Skeletal manifestations are the most debilitating characteristic and result in significant morbidities.

Telemedicine Use Among People With HIV in 2021: The Hybrid-Care Environment.

Background: Telemedicine use for the care of people with HIV (PWH) significantly expanded during the COVID-19 pandemic. During 2021, vaccine uptake increased and patients were encouraged to resume in-person care, resulting in a mixture of in-person and telemedicine visits. We studied how different patient populations used telemedicine in this hybrid-care environment.

The fate of acetabular fracture fixation at 10 years: rates of conversion to arthroplasty.

Background: Post-traumatic arthritis, implant failure, non-union or avascular necrosis may result in a total hip arthroplasty (THA) after acetabular fracture fixation (AFF). The aim of this study was to report the occurrence of THA after AFF and analyse factors that predict its occurrence.

Patients And Methods: All patients with AFF between 2010 and 2014, in a major trauma centre, were included.

Minimally invasive sacroiliac fusion, a case series, and a literature review.

Introduction: Non-autoimmune sacroiliac joint pain contributes to nearly a quarter of low back pain patients. Non-surgical management fails to satisfy patients. A new minimally invasive technique for sacroiliac stabilization has been introduced, defying the traditional rules of fusion.

Designing an electronic medical record alert to identify hospitalised patients with HIV: successes and challenges.

Objectives: Electronic medical record (EMR) tools can identify specific populations among hospitalised patients, allowing targeted interventions to improve care quality and safety. We created an EMR alert using readily available data elements to identify hospitalised people with HIV (PWH) to facilitate a quality improvement study intended to address two quality/safety concerns (connecting hospitalised PWH to outpatient HIV care and reducing medication errors). Here, we describe the design and implementation of the alert and analyse its accuracy of identifying PWH.

Time Between Viral Loads for People With HIV During the COVID-19 Pandemic.

Background: During the COVID-19 pandemic, patients experienced significant care disruptions, including laboratory monitoring. We investigated changes in the time between viral load (VL) checks for people with HIV (PWH) associated with the pandemic.

Setting And Methods: This was an observational analysis of VLs of PWH in routine care at a large subspecialty clinic.

Can Non-Contrast 3T MRI scans predict the type of labral procedure in hip arthroscopy?

Purpose: The study proposed a simple classification system that aimed at predicting the labral procedure during hip arthroscopy using images from unenhanced 3T MRI scans.

Patents And Methods: Forty patients undergoing hip arthroscopy had their MRI scans reviewed pre-operatively by one of two senior radiologists and classified into: type 1: stable labrum with intra-substance degeneration (no labral repair required), type 2: unstable labrum, no intra-substance degeneration (labral repair required), or type 3: unstable labrum with intra-substance degeneration (Labral repair not feasible). Hip arthroscopy is carried out by one of two surgeons and classified accordingly while blinded to the radiologists' assessment.

Telemedicine and visit completion among people with HIV during the coronavirus disease 2019 pandemic compared with prepandemic.

Objectives: Telemedicine became the primary mode of delivering care during the COVID-19 pandemic. We describe the impact of telemedicine on access to care for people with HIV (PWH) by comparing the proportion of PWH engaged in care prior to and during the COVID-19 pandemic.

Design And Methods: We conducted an observational analysis of patients enrolled in the Johns Hopkins HIV Clinical Cohort, a single-center cohort of patients at an urban HIV subspecialty clinic affiliated with an academic center.

Strategies of management of traumatic periprosthetic acetabular fractures around a pre-existing total hip arthroplasty.

Introduction: and aim: Traumatic peri-prosthetic fractures are relatively rare fractures that pose a significant surgical challenge. They have a fracture pattern that is different from its iatrogenic counterpart. This study aimed at reviewing the modalities of treatment of such injuries, proposing a treatment algorithm and reporting the outcomes of these injuries.

Incidence of DVT and PE after surgical reconstruction for pelvic and acetabular fractures: Does routine duplex scanning affect management?

Background: Prevention and detection of thromboembolism with pelvic and acetabular fractures remains controversial. The aim of this study was to evaluate a protocol using LMWH prophylaxis and duplex screening both pre-operatively (if there is a delay > 72 h to surgery) and post-operatively at day 5-7. We assessed the incidence of thromboembolism and associated risk factors.

An Overview of Medicare for Clinicians.

Background: Medicare is estimated to cover 14% of the population of the USA (Henry J Kais Fam Found 2017), over fifty million people. Despite covering a smaller percentage of the population than employer-sponsored insurance and Medicaid, Medicare is the most common payer for inpatient encounters. The Healthcare Cost and Utilization Project estimated that in 2015, Medicare was the primary payer for 39.

Does Routine Postoperative Computerized Tomography After Acetabular Fracture Fixation Affect Management?

Introduction And Aims: The use of routine postoperative computerized tomography (CT) scan after acetabular fracture reconstruction remains controversial. CT scan may provide more accurate detail regarding metalwork position, retained intra-articular fragments, and quality of reduction but does expose the patient to additional radiation dosage and incurs increased cost. The aim of this study was to evaluate a protocol of routine postoperative CT scan for all acetabular fractures after surgical fixation and assess the effect this has on patient management.

Management of a Mycobacterium immunogenum infection of a peritoneal dialysis catheter site.

Mycobacterium immunogenum is a member of the rapidly growing non-tuberculous mycobacteria and is a relatively new species identified within this group. An 81-year-old immune-competent male was diagnosed with M. immunogenum infection of his peritoneal dialysis catheter exit site and surrounding soft tissue.

Routine Postoperative Computed Tomography Scans After Pelvic Fracture Fixation: A Necessity or a Luxury?

Introduction: There is no consensus regarding the postoperative radiology imaging protocol after pelvic fracture surgery. Some institutes routinely scan all patients after their surgery, others do not. The aim of this study was to assess the value of routine use of computed tomography (CT) scans after pelvic fracture surgery and to determine the sensitivity of conventional plain radiographs and intraoperative fluoroscopy in detecting metalwork malposition.

Open complete anterior dislocation of the sacro-iliac joint in a 4-year-old boy: a case report of a rare injury with 5-year follow-up.

Pelvic fractures are uncommon in children and account for between 0.3 and 7.5% of all pediatric injuries.

Investigating the mutation resistance of nonnucleoside inhibitors of HIV-RT using multiple microsecond atomistic simulations.

Inhibiting HIV reverse transcriptase through the use of nonnucleoside reverse transcriptase inhibitors (NNRTIs) has become an essential component in drug regimens for the treatment of HIV. Older NNRTIs, such as nevirapine, are structurally rigid, exhibiting decreased inhibitory function on development of common mutations in the NNRTI-binding pocket, which is located around 10 Å from the catalytically active binding site. The newer generation of drugs, such as rilpivirine, are more flexible and resistant to binding pocket mutations but the mechanism by which they actually inhibit protein function and avoid mutations is not well-understood.