Donor age has no relevant role in biomechanical properties of allografts used in anterior cruciate ligament (ACL) reconstruction: A systematic review.

PURPOSE: Surgeons generally consider the donor age as a factor that negatively influences the quality of allograft used in anterior cruciate ligament (ACL) reconstruction, however, the available evidence does not clearly support this statement. The purpose of the study was to investigate if donor age influences the biomechanical properties of allografts used in ACL reconstruction. METHODS: A comprehensive literature search was conducted for all relevant articles using MEDLINE (PubMed), Scopus, and Cochrane Collaboration Library, according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis. Studies including the analysis of the correlation between biomechanical properties of the allografts and donor age were selected. The role of donor age was labelled as 'none' if absent, 'higher' or 'lower' if the properties were higher or lower in older specimens with respect to younger. The correlation was defined as 'weak' or 'strong' according to each study definition. RESULTS: No conflicting role of donor age was reported for modulus of elasticity, load to failure, strain, stiffness and displacement. The only parameters where the significant results were consistent were the tensile strength and the stress (low or moderate correlations). When considering the tested samples with a donor's age <65 years, a significant role of age was reported in only four out of 13 groups of graft tested (patellar tendon, fascia lata, anterior tibialis tendon and posterior tibialis tendon). CONCLUSION: The current literature did not allow to state that the donor age negatively influences the biomechanical properties of allografts, making it impossible to identify a clear age cut-off value to exclude them from ACL reconstruction procedures. LEVEL OF EVIDENCE: Level IV, systematic review.

Allergic Contact Dermatitis in the Right Forearm Following Splint Application for Distal Radius Fracture: A Rare Case of Plaster Cotton Allergy.

Allergic contact dermatitis (ACD) after splint or cast application (plaster of Paris) is infrequently encountered in orthopedic and traumatology clinical practice. This case study aims to elucidate the identification of ACD after splint application, highlight the conditions that warrant vigilance, and outline the precautions and optional treatment methods available in such instances. A 56-year-old right-hand dominant female presented to the emergency department after a fall on her right hand, manifesting pain, swelling, and tenderness without neurovascular injury. Radiographs revealed a distal radius fracture, leading to the application of a plaster of Paris splint. Within one day, she returned to the emergency department with severe itching and burning in the right arm. The splint was removed, and a dermatology consultation confirmed ACD due to undercast cotton padding. After splint removal, the patient's fracture treatment continued using a shoulder-arm sling until the lesion healed. Topical antihistamine ointment and oral corticosteroids were prescribed. Regular follow-up revealed the healing and union of the fracture by the fifth week, with minimal residual skin color changes. This case underscores the importance of prompt diagnosis and appropriate treatment in managing such occurrences. A key takeaway is the crucial need to schedule a follow-up appointment with the patient within one day of applying the cast or splint. Skin problems can emerge rather than neurovascular issues following casts or splints. Educating patients on warning signs, including skin irritation, neurovascular deficits, and symptoms of compartment syndrome, ensures the timely identification of significant issues. Healthcare practitioners should inquire about patients' histories of allergic skin reactions, taking a proactive approach to prevent ACD through early intervention and preventive measures.

Aspergillus fumigatus Septic Arthritis of the Wrist: A Report of a Rare Case in an Immunocompromised Patient.

Aspergillus fumigatus is a saprophytic fungus encountered as a pathogen in airborne lung infections. Although it commonly causes pulmonary infectious diseases, when disseminated, it may cause a systemic infection termed invasive aspergillosis, which is associated with high mortality and morbidity. Virtually, all organ systems may be involved. However, the musculoskeletal system is relatively uncommon. Here, we present a case of invasive aspergillosis in an immunocompromised patient involving the wrist joint, an exceedingly rare site. Our treatment choice is serial open debridement, irrigation, and intravenous antibiotics. This case study exemplifies the potential challenges in the identification and treatment of such an uncommon clinical condition. A thorough clinical and microbiological evaluation is essential for accurate diagnosis of fungal septic arthritis of the wrist. Aggressive early surgical treatment combined with appropriate early intravenous antibiotics is crucial for eradicating joint infection.

Data Hunches: Incorporating Personal Knowledge into Visualizations.

The trouble with data is that it frequently provides only an imperfect representation of a phenomenon of interest. Experts who are familiar with their datasets will often make implicit, mental corrections when analyzing a dataset, or will be cautious not to be overly confident about their findings if caveats are present. However, personal knowledge about the caveats of a dataset is typically not incorporated in a structured way, which is problematic if others who lack that knowledge interpret the data. In this work, we define such analysts' knowledge about datasets as data hunches. We differentiate data hunches from uncertainty and discuss types of hunches. We then explore ways of recording data hunches, and, based on a prototypical design, develop recommendations for designing visualizations that support data hunches. We conclude by discussing various challenges associated with data hunches, including the potential for harm and challenges for trust and privacy. We envision that data hunches will empower analysts to externalize their knowledge, facilitate collaboration and communication, and support the ability to learn from others' data hunches.

Evaluation of soluble CD14 subtype (presepsin) in burn sepsis.

BACKGROUND: Diagnosing sepsis is difficult in burn patients because of the inflammatory mediators that alter postburn metabolic profile. Here, we compare a new marker presepsin with procalcitonin (PCT), c-reactive protein (CRP) and white blood cell (WBC) in diagnosis and follow up of sepsis in burn patients. METHODS: Patients admitted to burn center of our institute were prospectively investigated. Presepsin, PCT, CRP and WBC levels were measured at admission and every 6h for first day and daily thereafter. At all timing samples, patients were classified as sepsis or non-sepsis according to the current American Burn Association Consensus Criteria (ABA) 2007. RESULT: 37 adult patients were evaluated. A total data of 611 time points were supplied. Sepsis time points differ significantly from non-sepsis in presepsin (p < 0.0001), PCT (p = 0.0012) and CRP (p < 0.0001) levels. Non-surviving patient results differ significantly from survivors in presepsin (p < 0.0001), PCT (p = 0.0210) and CRP (p = 0.0008). AUC-ROC % values for diagnosing sepsis were 83.4% for presepsin, 84.7% for PCT, 81.9% for CRP and 50.8% for WBC. Sepsis patients had significantly different presepsin, CRP and WBC but not PCT levels on their first day of sepsis compared to previous days. CONCLUSION: Plasma presepsin levels have comparable performance in burn sepsis.