Raynorcervantes0577

After one year of follow-up, the patient had no further recurrences of hip swelling. CONCLUSION This case of post-revision pseudotumor recurrence elucidates attributable patient, surgical, and implant factors with a discussion of diagnostics, management, and prognosis for patients with pseudotumor in non-metal-on-metal arthroplasty constructs. ©The Author(s) 2020. Published by Baishideng Publishing Group Inc. All rights reserved.BACKGROUND Airborne sports have become more popular in recent years. The number of accidents has increased linearly as athletes take increasingly greater risks to experience the adventurous spirit of this kind of sports. AIM To investigate the variety of injuries in airborne sport accidents, as well as which acute treatment these patients receive, both before and after admission to a level-one-trauma center. METHODS We performed a retrospective chart analysis at a major level-one-trauma center in Switzerland for 235-patients who were admitted following airborne sports injuries between 2010 and 2017. Patients' demographic data, injury patterns, emergency primary care procedures and intra-hospital care were recorded. RESULTS Overall, 718-injuries in 235-patients were identified; the spine was the most commonly affected region with 46.5% of injuries (n = 334/718) in 143-patients. In 69-patients (15.5%), the (non-spine) thorax was affected, followed by the lower and upper extremity, pelvis, head/face and abdominal injuries. Eleven-patients had to be intubated at the trauma site. Three patients were resuscitated after onset of pulseless-electrical-activity. Two-patients died in the resuscitation room. In 116-cases, surgery was indicated including 55-emergency surgeries. Another 19 patients (8.1%) were transferred to the intensive care unit. CONCLUSION Paragliders are most commonly affected, although the highest injury severities were identified for Building, Antenna, Span and Earth-jumping athletes. First responders, treating physicians and pilots should be aware of the risk for potentially serious and life-threatening injury with an in-hospital mortality of 0.9%. ©The Author(s) 2020. Published by Baishideng Publishing Group Inc. All rights reserved.BACKGROUND Postoperative delirium (POD) is one of the most common complications in older adult patients undergoing elective surgery. Few studies have compared, within the same institution, the type of surgery, risk factors and type of anesthesia and analgesia associated with the development of POD. AIM To investigate the following three questions (1) What is the incidence of POD after non-ambulatory orthopedic surgery at a high-volume orthopedic specialty hospital? (2) Does surgical procedure influence incidence of POD after non-ambulatory orthopedic surgery? And (3) For POD after non-ambulatory orthopedic surgery, what are modifiable risk factors? METHODS A retrospective cohort study was conducted of all non-ambulatory orthopedic surgeries at a single orthopedic specialty hospital between 2009 and 2014. Patients under 18 years were excluded from the cohort. Patient characteristics and medical history were obtained from electronic medical records. Patients with POD were identified using International Classifi5, P less then 0.001). CONCLUSION POD is lower (1.2%) than previously reported; likely due to the use of multi-modal regional anesthesia and early ambulation. Both fixed and modifiable factors are identified. ©The Author(s) 2020. Published by Baishideng Publishing Group Inc. All rights reserved.The demand for revision total hip arthroplasty (THA) is increasing. Information quality on the internet has been extensively analysed in relation to primary THA but no such analysis has ever been performed for revision THA. Our aim was to assess the quality and readability of this information. Three major internet search engines were searched for information on revision THA. All websites were assessed for quality of information using the DISCERN score, the Journal of the American Medical Association benchmark criteria and a novel scoring system specific to revision THA [Vancouver Revision Arthroplasty Information (VRAI) score]. Website readability was assessed, as was presence of the Health On the Net Foundation (HON) seal. The majority of websites (52%) were academic with a post-graduate reading level. Only 6.5% of websites had the HON seal. Twenty-eight percent of websites had a 'good' DISCERN score and only 28% had a 'good' score with the novel VRAI scoring system. Health information websites had significantly higher rates of 'good' VRAI scores (P = 0.008). Websites with the HON seal had significantly higher DISCERN scores (P = 0.01). All governmental websites were at a reading level suitable for patient review. Information on the internet relating to revision THA is of low quality, much lower than the quality of information on primary THA. We recommend governmental websites for their readability and health information websites for their quality of information specific to revision THA. Websites with the HON seal provide higher quality information and should be recommended to patients as reading material regarding revision THA. ©The Author(s) 2020. Published by Baishideng Publishing Group Inc. All rights reserved.On September 20, 2017 Hurricane Maria, a category 4 hurricane, made landfall on the eastern coast of Puerto Rico. This was preceded by Hurricane Irma, a category 5 hurricane, which passed just off the coast 13 d prior. The destruction from both Hurricane Irma and Maria precipitated a coordinated federal response which included the Federal Emergency Management Agency (FEMA) and the United States military. The United States Army dispatched the 14th Combat Support Hospital (CSH) to Humacao, a city on the eastern side of the island where Maria made landfall. The mission of the 14th CSH was to provide medical humanitarian aid and conduct disaster relief operations in support of the government of Puerto Rico and FEMA. During the 14th CSH deployment to Puerto Rico, 1157 patients were evaluated and treated. Fifty-seven operative cases were performed to include 23 orthopaedic cases. The mean age of the orthopaedic patients treated was 45.7 years (range 13-76 years). The most common operation was irrigation and debridement of open contaminated and/or infected wounds. Patients presented a mean 10.8 d from their initial injury (range 1-40 d). Fractures and infections were the most common diagnoses with the greatest delay in treatment from the initial date of injury. The deployment of the 14th CSH to Puerto Rico was unique in its use of air transport, language and local customs encountered, as well as deployment to a location outside the continental United States. These factors coupled with the need for rapid deployment of the 14th CSH provided valuable experience which will undoubtedly enable future success in similar endeavors. ©The Author(s) 2020. Published by Baishideng Publishing Group Inc. All rights reserved.Tacrolimus is an immunosuppressant produced by several Streptomyces species, widely used in transplantolgy and dermatology. In this report, attempts have been made to enhance tacrolimus productivity by altering the primary carbon source on culture media. In order to better understand the effects of glucose and maltose on tacrolimus biosynthesis, different carbon contents of these sugars were evaluated in the culture media, thus altering the carbonnitrogen ratio. The highest specific production achieved on this report was 10.46 mg/g at a carbonnitrogen ratio of 8.71.0 and maltose as carbon source. Using glucose as primary carbon source, the highest specific production achieved was 9.06 mg/g at a carbonnitrogen ratio of 8.51.0. The range of carbonnitrogen ratios evaluated for each sugar presented distinct behaviors. Glucose containing-media exhibited an initial linear downward trend, by the other hand, maltose containing-media exhibited an increasing tendency. Both glucose and maltose presented the highest specific production at 3 % of carbon source on media. Media containing more than 3 % of carbon content exerted carbon catabolite repression. The range of carbonnitogen ratios evaluated presented an increasing tendency on tacrolimus biosynthesis up to 3 % of glucose or maltose in the media, both carbon sources exerted the phenomenon of carbon catabolite repression with more than 3 % of carbon source on the media. © 2020 The Authors.Environmental ozone (O3) exposure has adverse effects on different body systems. This experimental work aimed to study the effect(s) of O3 exposure on the olfactory bulbs (OB) of Swiss Webster and C57BL/6J mouse strains, using Western blot technique. Both mice strains were exposed to different O3 doses for different number of exposures and durations. The results indicated that O3 exposure caused a significant increase in the level of the proteins involved in the oxidative stress state such as 4-hydroxynonenal (4HNE) and Cytochrome P450, family 1, subfamily A, polypeptide 1 (CYP1A1), in addition to the total OB proteins in Swiss Webster mouse strain. However, this effect was not observed in C57BL/6J mouse strain. Furthermore, CYP1A1 was completely absent in the Green fluorescent protein (GFP) C57BL/6J O3 exposed mice. Moreover, O3 exposure caused a significant decrease in the body weight of the tested mice from the two strains. © 2020 The Author.We report a fatal case of pembrolizumab-induced myasthenia gravis and myocarditis in a patient with metastatic bladder cancer. A 77-year-old man was aware of eye ptosis and diplopia after three weeks from first infusion of pembrolizumab, an anti-programmed cell death protein 1 monoclonal antibodies. He was diagnosed with myasthenia gravis, because he was positive on the edrophonium test and acetylcholine receptor antibody. As his echocardiography also revealed diffuse loss in wall motion with ejection fraction 29%, he was strongly suspected myocarditis. Although he was treated with prednisone and intravenous immunoglobulin, he was suddenly in cardiac arrest and passed away. © 2020 The Author(s).Severe hypertriglyceridemia (HTG) due to chylomicronemia is associated with acute pancreatitis and is related to genetic disturbances in several proteins involved in triglyceride (TG) metabolism. Lipase maturation factor 1 (LMF1) is a protein essential for the maturation of lipoprotein lipase (LPL). In this study, we examined the genetic spectrum of the LMF1 gene among subjects with severe HTG and investigated the functional significance of 6 genetic variants in vitro. All 11 exons of the LMF1 gene were sequenced in 101 Thai subjects with severe HTG. For an in vitro study, we performed site-directed mutagenesis, transient expression in cld cells, and measured LPL protein and LPL activity. We identified 2 common variants [p.(Gly36Asp) and p.(Pro562Arg)] and 12 rare variants [p.(Thr143Met), p.(Asn249Ser), p.(Ala287Val), p.(Met346Val), p.(Thr395Ile), p.(Gly410Arg), p.(Asp433Asn), p.(Asp491Asn), p.(Asn501Tyr), p.(Ala504Val), p.(Arg523His), and p.(Leu563Arg)] in 29 patients. In vitro study of the p.(Gly36Asp), p.(Asn249Ser), p.(Ala287Val), p.(Asn501Tyr), p.(Pro562Arg) and p.(Leu563Arg) variants, however, revealed that both LPL mass and LPL activity in each of the transfected cells were not significantly different from those in the wild type LMF1 transfected cells, suggesting that these variants might not play a significant role in severe HTG phenotype in our subjects. © 2020 The Authors.