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1.
Artículo en Inglés | MEDLINE | ID: mdl-35933286

RESUMEN

Trigger finger is a common condition affecting the hand. Therapeutic variability surrounds the management of trigger finger, especially in the mild cases. The aim of this study was to survey secondary care surgeons to describe the current management of trigger fingers. The steering group developed a survey for hand surgeons. Following piloting, the survey was distributed to hand surgeons in the United Kingdom and The Netherlands. A total of 713 plastic surgeons and orthopaedic surgeons were invited to participate in the online survey and 440 (62%) surgeons completed the survey. In both mild and moderate cases of trigger finger, steroid injection was the preferred treatment option. Open surgery was the treatment of choice for severe cases. However, there was variation in delivery of care, including type and dosage of steroid, site of injection, interval between injections, maximum number of injections, type of incision and treatment of patients with diabetes or rheumatoid arthritis. This highlights the need for a better evidence base for the treatment of trigger fingers.

2.
Nat Commun ; 13(1): 4639, 2022 Aug 08.
Artículo en Inglés | MEDLINE | ID: mdl-35941141

RESUMEN

We report strong ferromagnetism of quasiparticle doped holes both within the ab-plane and along the c-axis of Cu-O planes in low-dimensional Au/d-La1.8Ba0.2CuO4/LaAlO3(001) heterostructures (d = 4, 8 and 12 unit-cells) using resonant soft X-ray and magnetic scattering together with X-ray magnetic circular dichroism. Interestingly, ferromagnetism is stronger at a hole doped peak and at an upper Hubbard band of O with spin-polarization degree as high as 40%, revealing strong ferromagnetism of Mottness. For in-ab-plane spin-polarizations, the spin of doped holes in O2p-Cu3d-O2p is a triplet state yielding strong ferromagnetism. For out-of-ab-plane spin-polarization, while the spins of doped holes in both O2p-O2p and Cu3d-Cu3d are triplet states, the spin of doped holes in Cu3d-O2p is a singlet state yielding ferrimagnetism. A ferromagnetic-(002) Bragg-peak of the doped holes is observed and enhanced as a function of d revealing strong ferromagnetism coupling between Cu-O layers along the c-axis.

3.
J Phys Condens Matter ; 34(37)2022 Jul 18.
Artículo en Inglés | MEDLINE | ID: mdl-35797986

RESUMEN

The structural and magnetic properties of hole doped double perovskite La1.5Ca0.5CoFeO6have been investigated by measuring x-ray photoemission spectroscopy, neutron powder diffraction and magnetization. A ferrimagnetic transition is observed atTC∼ 167 K. The presence of anti-site disorder (ASD) in La1.5Ca0.5CoFeO6has also been demonstrated. Double re-entrant cluster glass transitions (T1∼ 11 K andTS∼ 35 K) were observed which has been attributed to the ASD effect. The presence of both large spontaneous exchange biasHSEB∼ 2.106 kOe and giant conventional exchange biasHCEB∼ 1.56 T at 5 K has also been observed which can be attributed to the coexistence of long range magnetic ordering and glassy state. The experimental observations were explained with the results obtained by the density functional theory calculation. The presence of double glassy states, large exchange-bias effect and different magnetic phases make this system a potential candidate for spintronic applications.

4.
Immunohematology ; 38(1): 13-16, 2022 Apr 29.
Artículo en Inglés | MEDLINE | ID: mdl-35852059

RESUMEN

A woman with autoimmune hemolytic anemia (AIHA) presented in the emergency department with life-threatening anemia (hemoglobin 3 g/dL). Exaggeration of preexisting chronic anemia to severe anemia after a recent red blood cell (RBC) transfusion led to suspicion of delayed hemolytic transfusion reaction. Given the urgency for transfusion along with a stronger suspicion for coexistence of an alloantibody, the dilution method proposed by Lawrence Petz and George Garratty was used to find an RBC unit for transfusion. An alloantibody with Fyb specificity was identified, which was masked by the coexistent autoantibody. This method is based on the assumption that the titers of an alloantibody are higher than that of autoantibody. Diluting the autoantibody would reveal the alloantibody and, for this purpose, a serial doubling dilution of serum is performed. This method has an important limitation of missing any alloantibodies with titers less than that of the autoantibody. In spite of this, this method may be of use at a resource-poor setting, where trained personnel and other reagents intended for advanced immunohematology methods are unavailable.


Asunto(s)
Anemia Hemolítica Autoinmune , Anemia Hemolítica Autoinmune/diagnóstico , Anemia Hemolítica Autoinmune/terapia , Autoanticuerpos , Transfusión Sanguínea , Transfusión de Eritrocitos/métodos , Femenino , Humanos , Isoanticuerpos
5.
AJNR Am J Neuroradiol ; 43(6): 850-856, 2022 06.
Artículo en Inglés | MEDLINE | ID: mdl-35672084

RESUMEN

BACKGROUND AND PURPOSE: Parry-Romberg syndrome is a rare disorder characterized by progressive hemifacial atrophy. Concomitant brain abnormalities have been reported, frequently resulting in epilepsy, but the frequency and spectrum of brain involvement are not well-established. This study aimed to characterize brain abnormalities in Parry-Romberg syndrome and their association with epilepsy. MATERIALS AND METHODS: This is a single-center, retrospective review of patients with a clinical diagnosis of Parry-Romberg syndrome and brain MR imaging. The degree of unilateral hemispheric atrophy, white matter disease, microhemorrhage, and leptomeningeal enhancement was graded as none, mild, moderate, or severe. Other abnormalities were qualitatively reported. Findings were considered potentially Parry-Romberg syndrome-related when occurring asymmetrically on the side affected by Parry-Romberg syndrome. RESULTS: Of 80 patients, 48 (60%) had brain abnormalities identified on MR imaging, with 26 (32%) having abnormalities localized to the side of the hemifacial atrophy. Sixteen (20%) had epilepsy. MR imaging brain abnormalities were more common in the epilepsy group (100% versus 48%, P < .001) and were more frequently present ipsilateral to the hemifacial atrophy in patients with epilepsy (81% versus 20%, P < .001). Asymmetric white matter disease was the predominant finding in patients with (88%) and without (23%) epilepsy. White matter disease and hemispheric atrophy had a higher frequency and severity in patients with epilepsy (P < .001). Microhemorrhage was also more frequent in the epilepsy group (P = .015). CONCLUSIONS: Ipsilateral MR imaging brain abnormalities are common in patients with Parry-Romberg syndrome, with a higher frequency and greater severity in those with epilepsy. The most common findings in both groups are white matter disease and hemispheric atrophy, both presenting with greater severity in patients with epilepsy.


Asunto(s)
Epilepsia , Hemiatrofia Facial , Leucoencefalopatías , Malformaciones del Sistema Nervioso , Atrofia/patología , Encéfalo/diagnóstico por imagen , Encéfalo/patología , Epilepsia/complicaciones , Hemiatrofia Facial/complicaciones , Hemiatrofia Facial/diagnóstico , Hemiatrofia Facial/patología , Humanos , Leucoencefalopatías/patología , Malformaciones del Sistema Nervioso/patología
6.
Int J Occup Saf Ergon ; : 1-10, 2022 May 20.
Artículo en Inglés | MEDLINE | ID: mdl-35593190

RESUMEN

Hand-operated tools transmit a high magnitude of vibration exposure to the hand-arm system that causes occupational diseases. The health effects caused in various countries for the past years due to usage of hand tools are necessary to identify the occupational disorders. Researchers have conducted various studies on biological effects, hand-transmitted vibration exposure and biodynamic responses throughout the years. This article goes over each of these studies in detail, as well as identifying areas where more research is needed. The majority of studies deal with the following topics: general guidelines for hand-transmitted vibrations; assessment techniques of vibration exposure; hand-tool evaluation methods; influence of hand-tool design to overcome the biomechanical effects; and finite element modelling for quantifying vibration exposure. In response to this, understanding the biodynamic behaviour of the hand-arm system is useful for better ergonomic intervention in hand tools to reduce fatigue and increase comfort.

7.
J Laryngol Otol ; 136(8): 747-749, 2022 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-35475481

RESUMEN

OBJECTIVES: This study aimed: to evaluate the association between coronavirus disease 2019 infection and olfactory and taste dysfunction in patients presenting to the out-patient department with influenza-like illness, who underwent reverse transcription polymerase chain reaction testing for coronavirus; and to determine the sensitivity, specificity, and positive and negative predictive values of olfactory and taste dysfunction and other symptoms in these patients. METHODS: Patients presenting with influenza-like illness to the study centre in September 2020 were included in the study. The symptoms of patients who tested positive for coronavirus on reverse transcription polymerase chain reaction testing were compared to those with negative test results. RESULTS: During the study period, 909 patients, aged 12-70 years, presented with influenza-like illness; of these, 316 (34.8 per cent) tested positive for coronavirus. Only the symptoms of olfactory and taste dysfunction were statistically more significant in patients testing positive for coronavirus than those testing negative. CONCLUSION: During the pandemic, patients presenting to the out-patient department with sudden loss of sense of smell or taste may be considered as positive for coronavirus disease 2019, until proven otherwise.


Asunto(s)
COVID-19 , Gripe Humana , Trastornos del Olfato , Anosmia , COVID-19/complicaciones , COVID-19/diagnóstico , Humanos , Trastornos del Olfato/diagnóstico , Trastornos del Olfato/epidemiología , Trastornos del Olfato/etiología , SARS-CoV-2 , Olfato , Gusto , Trastornos del Gusto/diagnóstico , Trastornos del Gusto/etiología
8.
Artículo en Inglés | MEDLINE | ID: mdl-35404294

RESUMEN

BACKGROUND: Several small randomized controlled trials (RCTs) and observational studies have compared high (15-20/7.5-10/7.5-10 mg/kg/dose) versus standard dose (10/5/5 mg/kg/dose) ibuprofen for patent ductus arteriosus (PDA) closure, with limited evidence on efficacy and safety. OBJECTIVE: To systematically review and meta-analyze studies of high versus standard dose ibuprofen for the closure of PDA in preterm infants. METHODS: Databases were searched for RCTs and observational studies assessing high compared to standard dose of ibuprofen for PDA closure for preterm infants until August 2021. The primary outcome was failure of PDA closure after the first course of ibuprofen. The secondary outcomes were the failure of PDA closure after a second course of ibuprofen, rates of PDA ligation, all-cause mortality prior to hospital discharge, bronchopulmonary dysplasia, necrotizing enterocolitis, bleeding disorders, oliguria, and serum creatinine after treatment. RESULTS: There were 6 studies with 369 patients (3 RCT, N = 190; 3 observational studies, N = 179). Compared to standard dose, high dose ibuprofen did not significantly decrease the failure rate of PDA closure in preterm infants after the first course (Relative risk (RR) 0.74, 95% confidence interval (CI) 0.53 -1.03, 6 studies, N = 369). High dose ibuprofen significantly decreased the rates of PDA ligation compared to standard dose (RR 0.33, 95% CI 0.16 -0.70, 5 studies, N = 309). INTERPRETATION: Based on low-grade evidence, high dose ibuprofen may more effectively reduce rates of PDA ligation compared to standard dose with no increase in adverse effects, neonatal morbidities and mortality.

9.
Transfus Clin Biol ; 2022 Mar 11.
Artículo en Inglés | MEDLINE | ID: mdl-35288280

RESUMEN

A delayed haemolytic transfusion reaction (DHTR) encompasses a positive direct antiglobulin test (DAT) developed anytime between 24 hours to 28days after cessation of transfusion, a positive eluate or a newly identified alloantibody in the plasma or serum along with features of haemolysis in the patient. Routinely, it is expected that with the transfusion of one unit of packed red cells in a patient of average height and weight, the haemoglobin level and hematocrit increase by 1 g/dL and 3% respectively. However, in a patient with DHTR, an inadequate rise of post-transfusion haemoglobin (<1 g/dL) or rapid fall in haemoglobin back to pre-transfusion levels is observed. Kidd antibodies are particularly known to cause DHTR, maybe alone or in unison with other antibodies. Detection of these alloantibodies is consequential in providing good transfusion support to these patients. These events may be difficult to detect as they may present as varied clinical features or immunological nuisances. In this case series, we have presented three cases of DHTR with special emphasis on their clinical presentations, immunohaematological evaluations, laboratory parameters and the role of proper transfusion support in these patients to avoid further complications.

10.
Ann R Coll Surg Engl ; 104(2): 37-40, 2022 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-35100858

RESUMEN

Superior mesenteric arteriovenous fistula is an extremely rare vascular malformation with most cases occurring following abdominal trauma or surgery. They are often asymptomatic or present with various abdominal symptoms with or without features of portal hypertension. A 30-year-old man developed fistulising of the superior mesenteric artery into the superior mesenteric vein following bowel resection surgery for an acquired midgut volvulus. Although endovascular management remains the treatment of choice in such cases due to increased morbidity of a repeat abdominal surgery, definite risks remain, such as coil migration, which happened in this case. The open surgical approach remains the only option in such instances.


Asunto(s)
Fístula Arteriovenosa/etiología , Anomalías del Sistema Digestivo/cirugía , Enfermedad Iatrogénica , Vólvulo Intestinal/cirugía , Arteria Mesentérica Superior/cirugía , Venas Mesentéricas/cirugía , Adulto , Fístula Arteriovenosa/diagnóstico por imagen , Fístula Arteriovenosa/cirugía , Angiografía por Tomografía Computarizada , Humanos , Masculino , Arteria Mesentérica Superior/diagnóstico por imagen , Venas Mesentéricas/diagnóstico por imagen , Tomografía Computarizada por Rayos X , Ultrasonografía
11.
Indian J Tuberc ; 69(1): 42-47, 2022 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-35074150

RESUMEN

BACKGROUND: cutaneous involevemtn is an important extrapulmonary manifestation of tuberculosis. It is a paucibacillary condition and has diverse clinical presentations. Sufficient data is not available regarding role of GeneXpertMTB/RIF in cutanoues tuberculosis. METHODS: in this study, BacT/Alert3D and response to antitubercular therapy were taken as gold standard and performance of GeneXpertMTB/RIF was evaluated against it in clinically and histopathologically suspected cases of cutaneous tuberculosis. RESULTS: forty seven patients were included in the study of which commonest presentation was scrofuloderma (42.6%) followed by lupus vulgaris (40.4%). Granulomatous inflammation on histopathology was seen in 75.5% patients on skin biopsy. Sic patients had extracutaneous focus of tuberculosis. In 14 (29.79%), culture of skin biopsy was positive for M. tuberculosis and all showed complete response to ATT in 6 months. GeneXpertMTB/RIF detected M. tuberculsois in 4 samples. CONCLUSION: GeneXpertMTB/RIF is not a reliable tool for diagnosis of cutaneous tuberculosis. Clinic-histopathological correlation along with response to ATT is needed for confirmation of diagnosis of cutaneous tuberculosis.


Asunto(s)
Mycobacterium tuberculosis , Tuberculosis Cutánea , Antituberculosos/uso terapéutico , Humanos , Mycobacterium tuberculosis/genética , Rifampin , Sensibilidad y Especificidad , Tuberculosis Cutánea/diagnóstico , Tuberculosis Cutánea/tratamiento farmacológico
13.
Ann R Coll Surg Engl ; 104(2): e37-e40, 2022 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-34807731

RESUMEN

Superior mesenteric arteriovenous fistula is an extremely rare vascular malformation with most cases occurring following abdominal trauma or surgery. They are often asymptomatic or present with various abdominal symptoms with or without features of portal hypertension. A 30-year-old man developed fistulising of the superior mesenteric artery into the superior mesenteric vein following bowel resection surgery for an acquired midgut volvulus. Although endovascular management remains the treatment of choice in such cases due to increased morbidity of a repeat abdominal surgery, definite risks remain, such as coil migration, which happened in this case. The open surgical approach remains the only option in such instances.


Asunto(s)
Fístula Arteriovenosa , Anomalías del Sistema Digestivo , Vólvulo Intestinal , Adulto , Fístula Arteriovenosa/diagnóstico por imagen , Fístula Arteriovenosa/etiología , Fístula Arteriovenosa/cirugía , Humanos , Enfermedad Iatrogénica , Vólvulo Intestinal/etiología , Vólvulo Intestinal/cirugía , Masculino , Arteria Mesentérica Superior/diagnóstico por imagen , Arteria Mesentérica Superior/cirugía , Venas Mesentéricas/diagnóstico por imagen , Venas Mesentéricas/cirugía
14.
J Hosp Infect ; 120: 31-35, 2022 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-34800611

RESUMEN

Early antibiotic administration is an important modifiable factor in reducing mortality from late-onset bloodstream infections in preterm infants. In a cohort study including 142 infants with non-coagulase negative staphylococcus bloodstream infection at two tertiary neonatal intensive care units, we identified typical practice-related factors that may be targeted to prevent delays in antibiotic administration. Collection of cerebrospinal fluid or urine sample before administering antibiotics, a longer time taken to site a peripheral intravenous catheter among those without pre-existing access, and a longer time taken to administer fluid boluses were associated with a longer than median time to antibiotic administration.


Asunto(s)
Recien Nacido Prematuro , Sepsis , Antibacterianos/uso terapéutico , Estudios de Cohortes , Humanos , Lactante , Recién Nacido , Unidades de Cuidado Intensivo Neonatal , Sepsis/tratamiento farmacológico , Sepsis/prevención & control
17.
Malays Orthop J ; 15(2): 47-54, 2021 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-34429822

RESUMEN

INTRODUCTION: Controversies exist in treatment of proximal humerus fractures as treatment options vary greatly from conservative management, closed pinning, stacked intramedullary nails, plating and hemi-arthroplasty. The purpose of this study is to study the fracture patterns of each case and document the functional outcome and complications post-operative in the management of proximal humerus fractures operated with proximal humerus plate. MATERIAL AND METHODS: Thirty five patients with closed proximal humerus fractures, above 18 years old, admitted in our tertiary care hospital during the study period were enrolled. Patients underwent open reduction internal fixation with proximal humerus locking plate under general anaesthesia. Post-operative patients were assessed using Constant and DASH scores. Complications were recorded. RESULTS: In our study the absolute Constant score of the study population increases at three months and six months and was found to be significant. Mean Constant score for 4-part fractures was 45.6 which were inferior as compared to 2-part and 3-part fractures (43.1 and 44.6, respectively). The mean Constant score at six months was 51.80 +/- 6.71. All three types of proximal humerus fractures showed significant improvement in the mean DASH score over our study period of six months and was found to be significant. Mean DASH score at six months was 27.97+/-12.84. Out of the 35 cases in the study two had complications. One had implant failure (Neer's type 3, 60-year-old female) and one had varus collapse (Neer's type 3, 45-year-old male). CONCLUSION: Due to angular stability and effective maintenance of the intraoperative fracture reduction during follow-up period, early post-operative mobilisation is possible which helps the patient to attain better shoulder range of motion and return to activity faster.

18.
Br J Oral Maxillofac Surg ; 59(8): 965-967, 2021 10.
Artículo en Inglés | MEDLINE | ID: mdl-34456077

RESUMEN

Bilateral sagittal split osteotomy (BSSO) is the most common orthognathic surgical procedure for the correction of facial deformities. Like any other surgical procedure, it is also associated with a risk of complications. One of these is described in the literature as notching at the lower inferior border of the mandible. Such discontinuity in the contour of the lower border is often a concern for patients. To overcome this complication, we recommend a modified vertical osteotomy cut while performing BSSO.


Asunto(s)
Procedimientos Quirúrgicos Ortognáticos , Osteotomía Sagital de Rama Mandibular , Humanos , Mandíbula/cirugía , Estudios Retrospectivos
19.
Transfus Clin Biol ; 28(4): 420-422, 2021 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-34252571

RESUMEN

Blood transfusion [BT] may sometimes result in a rare type of adverse event causing an isolated fall in blood pressure, commonly referred to as a hypotensive transfusion reaction [HyTR]. It is mediated by the biological response mediators, in particular cytokines such as bradykinin characterized by a sudden and unforeseen onset of hypotension as the predominant clinical manifestation during BT. In this case, the authors wish to highlight two consecutive episodes of abrupt-onset HyTR following blood administration in an Indian female patient, which, however, characteristically subsided on stopping the BT. She received appropriate management for the same. In fact, on discharge, we advised the patient to receive washed blood components, if needed, to prevent the recurrence of HyTR in future.


Asunto(s)
Hipotensión , Reacción a la Transfusión , Transfusión de Componentes Sanguíneos , Transfusión Sanguínea , Bradiquinina , Femenino , Humanos , Hipotensión/etiología
20.
AJNR Am J Neuroradiol ; 42(9): 1610-1614, 2021 09.
Artículo en Inglés | MEDLINE | ID: mdl-34244131

RESUMEN

Trigeminal neuralgia is a debilitating condition with numerous etiologies. In this retrospective case series, we report a cohort of patients with a rarely described entity, absence of Meckel cave, and propose this as a rare cause of trigeminal neuralgia. A search of the electronic medical record was performed between 2000 and 2020 to identify MR imaging reports with terms including "Meckel's cave" and "hypoplasia," "atresia," "collapse," or "asymmetry." Images were reviewed by 2 blinded, board-certified neuroradiologists. Seven cases of the absence of Meckel cave were identified. Seven patients (100%) had ipsilateral trigeminal neuralgia and ipsilateral trigeminal nerve atrophy, suggesting an association between absence of Meckel cave and trigeminal neuralgia. Absence of Meckel cave is a rare entity of unknown etiology, with few existing reports that suggest the possibility of an association with trigeminal neuralgia. Its recognition may have important implications in patient management. Future studies and longitudinal data are needed to assess treatment outcomes and added risks from surgical intervention in these patients.


Asunto(s)
Neuralgia del Trigémino , Humanos , Imagen por Resonancia Magnética , Estudios Retrospectivos , Resultado del Tratamiento , Nervio Trigémino/diagnóstico por imagen , Neuralgia del Trigémino/diagnóstico por imagen , Neuralgia del Trigémino/etiología
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