Intraneural Lipoma: A Rare Cause of Median Nerve Compression.

Intraneural lipomatous tumors are rare lesions that mostly affect the upper extremities. These slowly growing tumors can have a serious neurological and functional impact when they reach a significantly large size. We report herein a case of a 53-year-old female who presented with a large median nerve intraneural lipomatous tumor causing compression-related signs.

Septic Metallosis after Unicompartmental Knee Replacement: A Case Report and Literature Review.

Introduction: Metallosis following prosthetic hip and knee replacement is a well-known complication. However, unicompartmental knee arthroplasty (UKA) metallosis is rare. In this paper, we report a case of septic metallosis after unicompartmental knee replacement and we review the literature for the available treatment options.

Altered Left Ventricular Rat Gene Expression Induced by the Myosin Activator Omecamtiv Mecarbil.

To explore the impact of omecamtiv mecarbil (OM) on the gene expression profile in adult male rats. Fourteen male Wistar rats were randomly assigned to a single OM (1.2 mg/kg/h; n = 6) or placebo (n = 8) 30-min infusion.

Floating-Variant Medial Elbow Dislocation: A New Classification System.

Floating-variant elbow dislocation is a newly updated term used to describe several associations of fractures around the elbow and elbow dislocation that are still not adequately classified due to their rarity. Being extremely rare, only a handful of case reports are found in the literature describing this condition. Most of these papers described cases associated with the posterior or posterolateral direction of elbow dislocation, wherein each author has treated the fracture differently.

Management of Chronic Transtibial Articulocutaneous Fistula After All-Inside ACL Reconstruction: A Case Report.

Case: A 29-year-old man presented 2 years after anterior cruciate ligament (ACL) reconstruction by autologous semitendinosus graft and suspensory fixation on both tibial and femoral sides for chronic drainage of clear fluid from an anteromedial wound at the site of the tibial tunnel with a visible sinus tract. Magnetic resonance imaging showed a transtibial articulocutaneous fistula. The patient was treated by tunnel debridement, impaction bone grafting, bioresorbable interference screw, and cement to fully seal the tunnel.

Belt and suspender technique for bipolar bone loss in shoulder instability.

Bipolar glenohumeral bone loss is a challenging condition to address in patients with recurrent anterior shoulder instability. In this category of patients, most isolated soft-tissue procedures such as remplissage or infraspinatus capsulotenodesis are associated with high risk of failure and instability recurrence. Even bony procedures such as Latarjet may fail to provide absolute stability, and instability may eventually recur.

Beware of nonconvulsive seizures in prolonged disorders of consciousness: Long-term EEG monitoring is the key.

Objective: Evaluate the prevalence of epileptic seizures (ES) and epileptiform discharges (EDs) in patients with prolonged disorders of consciousness (DOC), and potential influence of amantadine on epilepsy.

Methods: We conducted a retrospective study in 34 patients hospitalized in a DOC care unit for prolonged DOC between 2012 and 2018, who received a long-term EEG monitoring (LTM). We reviewed the prevalence of ES, EDs and nonconvulsive seizures (NCSz), the type of DOC recovery treatment administered, and neurological outcome.

Arthroscopically Assisted Eaton-Littler Trapeziometacarpal Ligamentoplasty.

 Eaton-Littler ligamentoplasty has proven its efficacy in the treatment of trapeziometacarpal (TMC) instability.  In this article, we describe the arthroscopically assisted Eaton-Littler ligamentoplasty through two clinical cases.  Arthroscopy is used to accurately place the metacarpal bone tunnel and pass the slip of flexor carpi radialis tendon in the latter.

Percutaneous Sonographically Guided Release of Carpal Tunnel and Trigger Finger: Biomechanics, Clinical Results, Technical Developments.

The interventional use of sonography is growing fast, and percutaneous sonographically guided release is more and more used as minimally invasive treatment of carpal tunnel syndrome as well as trigger finger digit. The benefits of these procedures seem promising in clinical studies, but biomechanical studies comparing these procedures with open classical surgery are scarce. Minimally invasive releases of carpal tunnel and trigger finger could limit the phenomenon of tendon bowstringing observed after open surgery.

The myosin activator omecamtiv mecarbil improves wall stress in a rat model of chronic aortic regurgitation.

In patients with chronic aortic regurgitation (AR), excessive preload and afterload increase left ventricle wall stress, leading to left ventricular systolic dysfunction. Thus, the objective of the present study was to evaluate the effects of the myosin activator omecamtiv mecarbil (OM) on left ventricle wall stress in an experimental rat model of severe chronic AR. Forty adult male Wistar rats were randomized into two experimental groups: induction of AR (acute phase) by retrograde puncture (n = 34) or a sham intervention (n = 6).

Selepressin, a novel selective vasopressin V agonist, is an effective substitute for norepinephrine in a phase IIa randomized, placebo-controlled trial in septic shock patients.

Background: Vasopressin is widely used for vasopressor support in septic shock patients, but experimental evidence suggests that selective V agonists are superior. The initial pharmacodynamic effects, pharmacokinetics, and safety of selepressin, a novel V-selective vasopressin analogue, was examined in a phase IIa trial in septic shock patients.

Methods: This was a randomized, double-blind, placebo-controlled multicenter trial in 53 patients in early septic shock (aged ≥18 years, fluid resuscitation, requiring vasopressor support) who received selepressin 1.

MALDI-TOF MS typing of a nosocomial methicillin-resistant Staphylococcus aureus outbreak in a neonatal intensive care unit.

Background: The early detection of a methicillin-resistant Staphylococcus aureus (MRSA) outbreak is decisive to control its spread and rapidly initiate adequate infection control measures. Therefore, prompt determination of epidemiologic relatedness of clinical MRSA isolates is essential. Genetic typing methods have a high discriminatory power but their availability remains restricted.

Monitoring of kidney function in HIV-positive patients.

HIV-positive patients are at increased risk of developing chronic kidney disease. Although guidelines recommend regular monitoring of renal function in individuals living with HIV, the optimal frequency remains to be defined. In this review, we discuss the renal syndromes that may be identified at an earlier stage via routine assessment of kidney function, and provide guidance in terms of the frequency of monitoring, the most useful tests to perform, and their clinical significance.

Gonococcal ascending aortic aneurysm with penetrating ulcer and bovine arch.

We describe a patient with ascending aorta aneurysm and bovine aortic arch who initially presented with fever. A 65-year-old man with a 2-month history of intermittent fever was referred to our hospital and diagnosed as having a gonococcal ascending aorta aneurysm with penetrating ulcers. He was successfully treated by resection of the ascending aorta and ulcers, replacement of the aortic valve, and prolonged postoperative antibiotic therapy.

Relationship between the degree of portal hypertension and the onset of spontaneous bacterial peritonitis in patients with cirrhosis.

Background/aim: Spontaneous bacterial peritonitis (SBP) is a severe complication of cirrhosis but its exact pathogenesis has not yet been elucidated and the role of portal hypertension in the development of SBP has been suggested. The aim of this study was to test the hypothesis that an association exists between the degree of portal hypertension and the occurrence of SBP.

Methods: 292 patients with cirrhosis who underwent a measurement of the hepatic venous pressure gradient (HVPG) were retrospectively studied.