Pulsus Alternans: Caught in Action.

Pulsus alternans describes an arterial pulse waveform that shows alternating strong and weak beats despite a regular rhythm. Either discovered during physical examination or catheterization, pulsus alternans indicates severe left ventricular (LV) dysfunction and poor prognosis. There has been considerable debate about the underlying mechanism.

Monitoring recurrent angioedema: Findings from the Turkish angioedema control test validation study.

Background: Determination of control level in recurrent angioedema (RAE) is necessary to guide management. Here, we validated a Turkish version of the angioedema control test (AECT) for 4-week (AECT-4wk) and for 3-month (AECT-3mth) and assessed their utility in monitoring RAE.

Method: The recommended structured translation process for patient-reported outcome measures was completed.

Which Diastolic Pressure Should Be Used to Assess Diastolic Function?

Background: Although high left ventricular filling pressures [left ventricular (LV) end-diastolic pressure or pulmonary capillary wedge pressure (PCWP)] are widely taken as surrogates for LV diastolic dysfunction, the actual distending pressure that governs LV diastolic stretch is transmural pressure difference (∆PTM). Clinically, preferring ∆PTM over PCWP may improve diagnostic and therapeutic decision-making. We aimed to compare the clinical implications of diastolic function characterization based on PCWP or ∆PTM.

Is Pulmonary Capillary Wedge Pressure a Reliable Indicator of Postcapillary Pulmonary Hypertension?

Although current pulmonary hypertension (PH) guidelines recommend a pulmonary capillary wedge pressure (PCWP) >15 mm Hg for the detection of a postcapillary component, the rationale of this recommendation may not be quite compatible with the peculiar hemodynamics of PH. We hypothesize that a high PCWP alone does not necessarily indicate left-sided disease, and this diagnosis can be improved using left ventricle transmural pressure difference (∆ P). In this 2-center, retrospective, observational study, we enrolled 1,070 patients with PH who underwent heart catheterization, with the final study population comprising 961 cases.

Fracture line and comminution zone characteristics, and rotator cuff footprint involvement in OTA/AO 11C3-type proximal humeral fractures: complex proximal humerus fracture map.

Purpose: To identify fracture characteristics and zones of comminution as well as the relationship with anatomic landmarks and rotator cuff footprint involvement in OTA/AO 11C3-type proximal humerus fractures.

Methods: Computed tomography images of 201 OTA/AO 11C3 fractures were included. Fracture lines were superimposed to a 3D proximal humerus template, created from a healthy right humerus, after fracture fragment reduction on 3D reconstruction images.

Implant-Related Complications Do Not Interfere with Corrections with the Shilla Technique in Early Onset Scoliosis: Preliminary Results.

Growth-preservation techniques are utilized in early onset scoliosis (EOS) cases requiring surgical intervention. The Shilla technique corrects the deformity by reducing additional surgeries with its growth-guidance effect. As with other techniques, various problems can be encountered following the administration of the Shilla technique.

Treatment of neuropathic unstable knee osteoarthritis by a condylar, rotating-hinge prosthesis with cementless pentagonal stem: a case series.

Introduction And Importance: Total knee arthroplasty (TKA) in the neuropathic unstable knee (NUK) setting is classically a challenging orthopedic problem due to intraoperative technical difficulties and a higher frequency of periprosthetic complications. More recently, satisfactory results have been reported using improved constraints, stems and revision-type TKA components. The study aims to present long-term results of a small case series with NUK osteoarthritis reconstructed by a condylar, semi-constrained prosthesis with a polygonal, hydroxyapatite-coated (HA-coated) press-fit stem.

Treatment of Hip Dislocation in Cerebral Palsy with Extraarticular Intervention.

PURPOSE OF THE STUDY Hip dislocation is one of the major causes of disability in children with cerebral palsy (CP). Surgical treatment can be achieved using different techniques including proximal femoral varus derotation osteotomy (FVDRO), pelvic osteotomies, and open hip reduction (OHR). However, we claim that pathologies originating from extraarticular structures in the dislocated hip in CP can be reconstructed by extraarticular methods and OHR may not always be necessary.

COMBINED PLATE VERSUS EXTERNAL FIXATION FOR DISTAL RADIUS FRACTURES.

Objectives: This study aimed to compare the functional and radiological results of patients who had intra-articular comminuted distal radius fractures and were operated on with external fixation percutaneous pinning or the volar-dorsal combined plate osteosynthesis.

Methods: In this study, 49 patients operated on and followed up for the comminuted distal radius fractures between May 2015 and January 2019 were retrospectively evaluated. The surgical outcomes of the patients, who were operated on with combined dorsal-volar plate osteosynthesis or external fixation percutaneous pinning, were compared in this study.

Corticosteroid, Platelet-Rich Plasma, and Ozone Injections for Sinus Tarsi Syndrome.

Background: Sinus tarsi syndrome is characterized by permanent pain on the anterolateral side of the ankle due to chronic inflammation characterized by fibrotic tissue remnants and synovitis accumulation after repeated traumatic injuries. Few studies have documented the outcome of injection treatments for sinus tarsi syndrome. We sought to determine the effects of corticosteroid and local anesthetic (CLA), platelet-rich plasma (PRP), and ozone injections on sinus tarsi syndrome.

Long-term opioid medication profile of European adult spinal deformity patients: minimum five years follow-up study.

Background Context: There remains significant variability in the use of postoperative opioids. On one end, it is proven that appropriate pain control is a critical aspect of patient management; on the other end, past few decades have been associated with major increases in opioid-related overdoses and addiction treatment. We hypothesized that several pre- and postoperative risk factors affecting long-term opioid use could be identified.

Risk factors related reduction loss in nonoperatively treated Type II supracondylar humerus fractures.

Background: Controversies continue about the optimal treatment method for extension Type II supracondylar humerus fractures (SCHFs). Although most patients are successfully treated with closed reduction and plaster casting, in some patients, the reduction initially obtained is lost during the time in the plaster cast. The aim of this study was to determine the risk factors causing reduction loss.

Fracture lines and comminution zones in acetabular fractures based on three dimensional computed tomography.

Purpose: To characterize the fracture patterns of acetabular fractures and create fracture maps and comminution zones based on three-dimensional (3D) computed tomography (CT) images.

Methods: Sixty-eight computed tomography images of 67 patients (47 male [70.1%] and 20 female [29.

Ultrasonographic Measurement of Median Nerve Cross-Sectional Area in Evaluating Carpal Tunnel Release Outcomes.

Purpose: Earlier research has explored carpal tunnel release (CTR) surgery outcomes using electrodiagnostic tests (EDX). However, evaluation of the median nerve before and after CTR by ultrasound (US) is understudied. This study aimed to establish the outcomes of CTR by EDX and US, and examine the correlation between the clinical improvement and US after CTR.

Correlation between Harris, modified Harris hip, and Oxford hip scores of patients who underwent hip arthroplasty and hemiarthroplasty following hip fracture.

Background: Harris hip score (HHS), modified HHS (MHHS), and Oxford hip score (OHS) were designed to determine the functional outcomes after primary total hip arthroplasty (THA). The aim of this study was to evaluate the correlation between MHHS, HHS, and OHS in different populations of arthroplasty such as primary THA, revision THA, THA for Crowe Type IV developmental dysplasia of the hip (DDH), and hip hemiarthroplasty (HA).

Methods: A total of 399 patients (254 females and 145 males) that included 128 cases of primary THA, 36 of revision THA, 200 of HA, and 35 of THA with femoral shortening osteotomy with a minimum of 24 months of follow-up were included.

A new biomarker in the differential diagnosis of epileptic seizure: Neurogranin.

Aim: The aim of this study was to determine the level of serum NGRN in epilepsy patients presenting at the Emergency Department with complaints of an epileptic seizure, and to thus evaluate the utility of this biomarker in the differentiation of epilepsy and PNES patients from each other.

Material Methods: The study included patients aged >18 years who had experienced an epileptic seizure or were experiencing an epileptic seizure proven with EEG. All patients with brain disease of structural or infectious cause were excluded from the study (dementia, stroke, intracranial mass, meningitis, encephalitis, Creutzfeldt-Jacobs disease, abscess, etc).

Individual and Combined Anatomic Risk Factors for the Development of an Anterior Cruciate Ligament Rupture in Men: A Multiple Factor Analysis Case-Control Study.

Background: No comparative studies have evaluated anatomic risk factors in a large cohort including both patients with anterior cruciate ligament (ACL) ruptures and healthy participants.

Purpose: To determine which anatomic parameters are independently associated with an ACL rupture and the diagnostic values of the individual and combined anatomic parameters.

Study Design: Case-control study; Level of evidence, 3.

Comparison of Computed Tomography, Traction, and Inverted Grayscale Radiographs for Understanding Pilon Fracture Morphology.

Background: There have been no studies evaluating the usefulness of grayscale radiographs in extremity fractures. We aimed to compare the ability and reliability of traction radiographs vs traction grayscale inversion radiographs to detect fracture fragment and comminution zones in comminuted tibia pilon fractures.

Methods: Plain radiographs and grayscale inversion images of 60 patients with Orthopaedic Trauma Association/AO Foundation type C3 fracture were evaluated by 20 observers (15 orthopaedic surgeons and 5 radiologists) after traction had been applied.

Factors Affecting Prolonged Postoperative Pain and Analgesic Use After Arthroscopic Full-Thickness Rotator Cuff Repair.

Background: Postoperative pain and analgesic use after arthroscopic rotator cuff repair remain important issues that affect rehabilitation and overall outcomes.

Purpose: To evaluate the pre- and intraoperative factors that may cause prolonged duration of postoperative pain and analgesic use.

Study Design: Case-control study; Level of evidence, 3.

Distal metatarsal osteotomy and dorsal neutralization plate in the treatment of hallux valgus.

Purpose: Hallux valgus is a disease that can be treated with many different surgical procedures. In our study, we aimed to compare patients with and without dorsal neutralization plate after distal metatarsal osteotomy and fixation with compression screws.

Methods: The files of 59 patients with 89 feet operated with the diagnosis of moderate degree hallux valgus have been examined retrospectively.

Circulating Levels of MicroRNAs in Hypertrophic Cardiomyopathy: The Relationship With Left Ventricular Hypertrophy, Left Atrial Dilatation and Ventricular Depolarisation-Repolarisation Parameters.

Background: MicroRNAs are small, endogenous, non-coding RNAs that regulate the expression of many genes. It has recently been shown that circulating microRNAs may be biomarkers of hypertrophy and fibrosis in patients with hypertrophic cardiomyopathy (HCM).

Objective: To determine whether circulating levels of microRNAs involved in HCM are associated with electrocardiographic and echocardiographic parameters.

Longitudinal assessment of meibomian glands and tear film layer in systemic isotretinoin treatment.

Purpose: This study aimed to analyze the changes in meibomian glands (MGs) and tear film layer over time in patients taking systemic isotretinoin treatment.

Methods: Patients who received systemic isotretinoin treatment between 4 and 8 months were prospectively followed up. In addition to full ophthalmologic examination, MG dysfunction (MGD), noncontact meibography, noninvasive and invasive tear break-up time (TBUT), ocular surface disease index (OSDI), corneal staining, and eyelid margin abnormality scores were recorded before, during, and after treatment.