A Unique Patellar Tendon Rupture and Small Tibial Avulsion fracture in a Post-Menopausal Patient.

Introduction: This study highlights the case of a 75-year-old female patient with a history of bilateral knee replacements who presented with a subacute patellar tendon rupture that occurred after falling on her left knee. Case Report: The patient had a left total knee replacement one year previously and came in for her one-year follow-up. She presented 3 weeks after her injury with a high-riding patella and a small tibial tubercle avulsion fracture on X-ray, yet she did not experience much pain nor any loss of active extension of her left knee. Despite the severity and subacute presentation of the patient's patellar tendon injury, conservative measures that included physical and occupational therapy was recommended instead of surgery due to her paradoxical retention in gross function of her left knee. Conclusion: Showcasing this patient's case may provide further understanding of patellar tendon ruptures and tibial avulsion fractures, specifically factors that allow the patient to retain strength and extensor function in her knee to curb the need for surgery.

Effects of consuming diets containing various fats or citrus flavanones on plasma lipid and urinary F2-isoprostane concentrations in overweight cats.

OBJECTIVE: To compare in overweight cats the effects of feeding moderate-energy diets with moderate fat content but with saturated fat (beef tallow), saturated fat plus citrus flavanones, or monounsaturated fat (olive oil) on plasma lipids and urinary F2-isoprostane concentrations. ANIMALS: 20 overweight cats with mean+/-SD body weight of 5.2+/-0.2 kg and mean body condition score of 7.8+/-0.2 (9-point scale). PROCEDURES: Body weight, plasma total cholesterol and triacylglycerol concentrations, and urinary F2-isoprostane concentration (as marker of oxidative stress) were measured at the beginning of the study, when the cats were fed a maintenance diet, and after 1, 3, and 5 months of consuming test diets. RESULTS: In overweight cats, citrus flavanones supplementation of the saturated fat diet was associated with lower energy intake and with lower plasma lipids and urinary F2-isoprostane concentrations than in cats fed the saturated fat alone. Monounsaturated fat feeding resulted in lower food intake than in cats fed saturated fat. However, plasma lipids concentrations remained within reference limits throughout the study. CONCLUSIONS AND CLINICAL RELEVANCE: Although the clinical relevance of these findings is unknown, the significant differences detected indicated that lower energy intake with citrus flavanones supplementation or with substitution of saturated fat for monounsaturated fat could be good strategies for decreasing plasma lipids concentration and oxidative stress in overweight cats, even before considerable loss of body weight is observed.

Sacroiliac Stretching Improves Glenohumeral Internal Rotation Deficit of the Opposite Shoulder in Baseball Players in a Randomized Control Trial.

INTRODUCTION: Glenohumeral internal rotation deficit (GIRD) is a well-documented finding in throwing athletes. PURPOSE: To investigate whether stretching the contralateral sacroiliac (SI) joint can improve GIRD in baseball players. METHOD: After internal shoulder rotation was measured in 23 minor league baseball players, the players randomly were assigned to either a control (ie, sleeper stretch of the dominant shoulder) or experimental (ie, SI joint stretch contralateral to the dominant shoulder) group. Afterward, internal rotation (IR) of their dominant shoulders was remeasured. RESULTS: The mean initial end-range IR was 68.6° (SD = 7.9°) in the sleeper stretch group (n = 8) and 64.5° (SD = 5.1°) in the SI joint stretch group (n = 15). After stretching, the sleeper stretch group's mean end-range IR was 72.1° (SD = 7.2°), a 3.5° improvement (P = 0.1058), whereas the contralateral SI joint stretch group's mean end-range IR was 71.9° (SD = 6.6°), a 7.4° improvement (P = 0.0041). CONCLUSIONS: Stretching the contralateral SI joint improved GIRD more than the sleeper's stretch.

Plant polyphenol intake alters gene expression in canine leukocytes.

BACKGROUND/AIMS: Polyphenol compounds may explain most of the health-related beneficial effects of plants and vegetables, mainly through their antioxidant properties. The aim of the study was to assess the main changes on leukocyte gene expression of dogs caused by intake of three natural polyphenol-rich extracts and to compare them with caloric restriction. METHODS: 20 female dogs were divided into 5 groups: control fed ad libitum (C), caloric-restricted to 30% less than control (CR), and 3 groups fed ad libitum supplemented with citrus extract (CE), green tea extract (GTE) or grape seed extract (GSE). Leukocytes gene expression was analyzed in a specially designed microarray. RESULTS: CE treatment mainly downregulated genes related to inflammative (IL-8, VLA-4) and cytotoxic response (GRP 58) as well as proliferation of leukocytes. GTE induced gene expression related to leukocyte proliferation and signaling (GNAQ, PKC-B). GSE upregulated some of the genes increased by CE treatment. CR downregulated genes related with energy metabolism (ATP5A1, COX7C) and inflammatory markers (VLA-4). CONCLUSION: A chronic ingestion of citric, grape seed and green tea polyphenols is able to modulate canine leukocyte functions through changes in gene expression. CE ingestion reduces expression of some genes also diminished by a 30% caloric restriction.

Caracterización de los pacientes infectados por Helicobacter pylori durante un trienio / Characterization of patients infected by Helicobacter pylori during a triennium

Se realizó una investigación descriptiva y retrospectiva de los pacientes mayores de 18 años a los que se les practicó endoscopia del tracto digestivo superior en el Servicio de Gastroenterología del Hospital Clínica Popular "Simón Bolívar" del Estado Carabobo, en la República Bolivariana de Venezuela, en el periodo de enero del 2010 a diciembre del 2012, con vistas a comprobar si existía infección por Helicobacter pylori en esta porción del sistema digestivo, según algunas variables clínicas, epidemiológicas y endoscópicas de interés. Entre los resultados sobresalientes de la casuística figuró la infección por dicha bacteria, que fue más frecuente en las edades de 31-60 años y en el sexo femenino; de igual modo, la epigastralgia y la pangastritis eritematosa erosiva estuvieron mayormente asociadas al microorganismo. Pudo concluirse que la endoscopia es el pilar para el diagnóstico del Helicobacter pylori.

A descriptive and retrospective investigation of the patients older than 18 years to whom an endoscopy of the higher digestive duct was practiced in the Gastroenterology Service from "Simón Bolívar" People's Clinic Hospital, in Carabobo State, Bolivarian Republic of Venezuela was carried out in the period of January, 2010 to December, 2012, aimed at checking if there was infection due to Helicobacter pylori in this zone of the digestive system, according to some clinical, epidemiological and endoscopic variables of interest. Among the excellent results of the case material there was the infection caused by this bacteria which was more frequent in the 31-60 years age group and in the female sex; also, the epigastralgia and the erosive erythematous pangastritis were mostly associated with the microorganism. It could be concluded that the endoscopy is the key stone for the diagnosis of Helicobacter pylori.

Development and characterization of a canine skin equivalent.

The development of a complex cellular model, which incorporates the basic cell components of the dog skin, would be a useful tool to investigate the biology and pathology of canine skin and also to replace animal testing partially. The aim of the present study was to develop and characterize a canine skin equivalent. Epidermal keratinocytes and dermal fibroblasts were freshly isolated from skin biopsies from healthy dogs. Fibroblasts were embedded into a bio-matrix from collagen type I matrix protein; this built the scaffold where the keratinocytes were seeded, at air exposed conditions. At 3, 7, 15 and 21 days of culture in special growth media, skin equivalents were analysed by histological, immunohistochemical and electron microscopical techniques. At 15 days, keratinocytes underwent differentiation to a multilayer epidermis with stratum basal, stratum spinosum, stratum granulosum and stratum corneum. Expression of epidermal cytokeratins in keratinocytes was detected by immunhistochemistry, and followed the same pattern than in the normal canine epidermis. Fibroblasts from the skin equivalent expressed vimentin as dermal fibroblasts do. A basement membrane (BM) was observed underneath the epidermis; ultrastructurally, it was similar to the normal canine BM and collagen IV and laminin 5 were detected immunohistochemically as major components of this structure. Skin equivalents developed from canine cutaneous cells presented a similar morphological structure than healthy canine skin. Moreover, the immunohistochemical analysis revealed the expression of the major markers of the epidermis (keratins), dermis (vimentin) and BM (collagen type IV, laminin 5).

Readjustable transobturator sling: a novel sling procedure for male urinary incontinence.

Post-prostatectomy incontinence remains a significant problem for both patients and urologists. We report a case and the surgical technique of successful sling in the treatment of post-prostatectomy urinary incontinence. Sling surgery was performed on a 69-year-old male patient with severe urinary incontinence (6 pads/day) following radical prostatectomy. The procedure was conducted through the transobturator approach using a sling with a silicone foam pad to protect the urethra. At the 7-month follow-up the patient is using only 1 pad/day. We consider this operation an alternative to artificial urinary sphincter in cases of male sphincter incontinence.

La inyección periuretral de pasta de Teflón, como recurso terapeutico en le incontinencia de orina: nuestra experiencia / Periurethral injection of Teflon as therapeutic resource in urinary incontinence: our experience

Se presentan ocho (8) casos consecutivos de incontinencia urinaria por insuficiencia uretral, tratados con inyección periuretral de teflón en pasta. Se obtuvieron cuatro (4) curaciones (en una de éstas, luego de la tercera inyección). En tres (3) pacientes recidivó la incontinencia de orina después de un buen resultado inicial, debido a la eliminación espontánea del teflón de la uretra, teniendo prevista la reinyección. En un caso en que la inyección resultó técnicamente imposible, como es natural, no se obtuvo ningún resultado. Se destaca la sencillez, efectividad y buena tolerancia de este novedoso recurso