Christoffersenfoss9983

Return to sports rate of chronic meniscus repair concurrent with Anterior Cruciate Ligament (ACL) reconstruction remains unclear, especially there is no well-defined return to sports criteria for evaluation. The purpose of this retrospective study was to determine the success rate of chronic locked bucket-handle meniscal tear (BHMT) repair with concomitant ACL reconstruction.

This study includes 51 chronic ACL injury patients with a locked meniscal tear of at least 6 weeks who underwent surgery. All cases were treated with arthroscopic BHMT repair and ACL reconstruction between 2017 and 2020. Patient demograph-ics, chronicity, pre-operative, and intraoperative surgical variables which associated with return to sports were defined. BHMT was repaired with an all-in-side meniscus repair and/or combined repair procedure first, then an anatomic outside-in ACL reconstruction using a suspension device for femoral fixation was performed. Patients underwent same rehabilitation program with the goal of return-ing tegardless of the delay in time to surgery.

Majority of the patients who underwent ACL reconstruction with BHMT repair return to their pre-operative activity levels in 8 months. All neglected BHMTs with concomitant chronic ACL rupture should be repaired in a single-stage surgery if the half plane-concave shape of the menisci has been preserved regardless of the delay in time to surgery.

Exsanguination can be fatal in patients with traumatic brain injury (TBI). We aimed to analyze and compare the prognostic performances of injury severity score (ISS), revised trauma score (RTS), shock index (SI), and modified early warning score (MEWS) for predicting massive transfusion (MT) in severe trauma patients with TBI.

In this retrospective observational study, severe trauma patients with TBI who visited our emergency department between January 2018 and December 2020 were included in the study. TBI was considered when abbreviated injury scale was 3 or higher. The primary outcome was MT.

A total of 1108 patients were included, and MT was performed in 92 (8.3%) patients. Receiver operating characteristic analyses were performed to evaluate the accuracy of ISS, RTS, SI, and MEWS for predicting MT. selleck chemicals llc The area under curves (AUCs) of ISS, SI, RTS, and MEWS for predicting MT were 0.725 (95% confidence interval [CI], 0.698-0.751), 0.676 (95% CI, 0.648-0.704), 0.769 (95% CI, 0.743-0.793), and 0.808 (95% CI, 0.784-0.831), respectively. The AUC of MEWS was significantly different from the AUCs of ISS and SI but not the AUC of RTS for predicting MT. In a multivariate analysis, Glasgow Coma Scale (odds ratio [OR], 0.856; 95% CI, 0.803-0.911), body temperature (OR, 0.596; 95% CI, 0.386-0.920), and fresh frozen plasma (OR, 2.031; 95% CI, 1.794-2.299) were independently associated with MT. MEWS (OR, 1.425; 95% CI, 1.256-1.618) was independently associated with MT after adjustment for confounders.

MEWS may be a useful tool for predicting MT in severe trauma patients with TBI.

MEWS may be a useful tool for predicting MT in severe trauma patients with TBI.

Appendicitis is one of the most common surgical emergencies among children. In this retrospective clinical study, we attempted to determine the effects of the COVID-19 pandemic period on hospital admission time and length of hospital stay (LOS) in pediatric appendicitis cases.

We retrospectively compared pediatric appendectomies from the date of the first reported COVID-19 case to June 1, 2020, which is considered as the start of the normalization process, with pre-pandemic pediatric appendectomies of the same number of days in terms of age, gender, hospital admission time, LOS, parental educational level, laboratory values, and histopathological findings.

There was an average increase of 2 days in the time from the onset of symptoms to hospital admission in pediatric appen-dicitis patients in the COVID-19 period (p=0.001). Furthermore, C-reactive protein value was statistically significantly higher in the COVID-19 period (p=0.018). Given the LOS, it was calculated as an average of 5 days in the pre-pan of complicated appendicitis.

The hospital admission time of pediatric appendicitis patients is significantly prolonged in the COVID-19 pandemic, but this prolongation had no histopathological effect. During the pandemic, the recovery of patients who required urgent treatment during the 'stay-at-home' period was also negatively affected. Notwithstanding, we are of the opinion that the absence of an increase in the LOS may be due to the willingness of both families and physicians to keep the LOS as short as possible. Despite the increase in hospital admission time in pediatric appendicitis during the Covid 19 pandemic process, the lack of increase in the rate of complicated appendicitis may be an indicator of the importance of other factors in the development of complicated appendicitis.

The purpose of the study was to compare the functional and radiological results of the conservatively and surgically treated displaced acetabular fractured patients.

The study included 61 patients with a displaced acetabulum fracture over the age of 18, who have been treated con-servatively or surgically for acetabular fractures, between 2000 and 2014. Patients were divided into two groups according to their treatment type. Group 1 consisted of conservatively treated 31 between 2000 and 2010 patients and Group 2 consisted of surgically treated 30 patients between 2010 and 2014. The fractures were classified according to Judet and Letournel classification. Clinical evaluation of the patients was conducted according to Modified Merle D'Aubigne Score, SF-36, and Harris Hip Score. Radiological evaluation was evaluated according to Matta's Radiological Evaluation Criteria. Kolmogorov-Smirnov, t-test, Mann-Whitney U-test, and two Wilcoxon paired sample tests were used for statistical analysis. The significance e outcome of conservatively managed fractures is not bleak. We think that there is an alternative to surgical treatment in displaced acetabular fractures and that similar functional results can be obtained in selected cases.Despite advances in cancer treatment, chronic myeloid leukemia (CML) is still one of the leading causes of death in the world. Due to the role of inflammation in cancer promotion and progression, thus use of anti-inflammatory agents may suppress cancer cell growth. In this study, we used two anti-inflammatory drugs, cilostazol and meloxicam, for the treatment of CML. Cell viability was measured using 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assay and the synergism occurrence was calculated by compusyn software. Annexin V/PI test and Hoechst staining were used to determine the apoptosis rate. To determine the pathway of apoptosis induction, the expression of BCL2 Associated X (Bax) and B-cell lymphoma-2 (Bcl-2) apoptotic genes and caspases activity were evaluated. The cell cycle was analyzed by propidium iodide (PI) staining and flow cytometry. Western blot analysis and immunofluorescence were performed to estimate alterations in Ak strain transforming-1 (AKT-1), phosphprylated AKT-1 (p-AKT-1), adenosine mono-phosphate-kinase (AMPK), and phosphorylated AMPK (p-AMPK) proteins and BCR/ABL and c-Myc distribution, respectively. Results showed that cilostazol, meloxicam, and their combination drug reduced cell viability (p  less then  0.05). Compared with control, expression of Bax and Bcl-2 decreased in treated cells, respectively (p  less then  0.05). The caspase-9 activity increased in treated cells compared to control cells (p  less then  0.001). The applied drugs decreased the protein level of p-AKT-1 while increasing the p-AMPK protein level (p  less then  0.05). BCR/ABL and c-Myc Protein distribution significantly decreased in treated cells. In conclusion, the combination drug had more cytotoxic effects than cilostazol and meloxicam alone and induced apoptosis by inhibiting AKT-1 activation and c-Myc reduction. Therefore using combination drugs effectively can treat cancers of CML origin.

To evaluate outcomes and risk factors for death in patients with rheumatoid arthritis (RA) who developed Pneumocystis pneumonia (PCP).

We included RA patients who were diagnosed with PCP at seven participating community hospitals between July 2005 and October 2020. Clinical features were compared between survivors and non-survivors. Disease-modifying antirheumatic drugs (DMARDs) before PCP onset and after PCP recovery were also examined.

Seventy RA patients developed PCP, and among them, 60 (85.7%) received methotrexate (MTX) monotherapy (40%) or MTX combination therapy with other DMARDs (45.7%). PCP was more likely to occur after 12 months of MTX monotherapy and within 3 months of MTX combination therapy. Thirteen patients (18.6%) died despite PCP treatment. Multivariable logistic regression analysis revealed that coexisting RA-associated interstitial lung disease (RA-ILD; odds ratio [OR] 6.18, 95% confidence interval [CI] 1.17-32.63) and delayed PCP treatment with anti-Pneumocystis drugs (OR 15.29, 95% CI 1.50-156.15) are significant risk factors for PCP mortality in RA patients. Most survivors successfully resumed DMARD therapy without PCP prophylaxis; one recurrent PCP case was observed during follow-up (median, 4.1 years).

To avoid a treatment delay, RA patients should be followed-up for signs and symptoms of PCP development, especially those with RA-ILD.

To avoid a treatment delay, RA patients should be followed-up for signs and symptoms of PCP development, especially those with RA-ILD.

The eutectic mixture of local anesthetics (EMLA) is an effective cutaneous anesthetic, although its application is time consuming and poses a risk of methemoglobinemia. Currently, the efficacy of topical 10% lidocaine cream is unclear.

To compare the onset, anesthesia depth, and duration of topical 10% lidocaine and EMLA cream.

The randomized, split-body, comparative trial performed on 40 participants who received a topical 10% lidocaine cream or EMLA on forearms for 15-150 min. Pain was stimulated using a 21-gauge needle insertion and evaluated with the Verbal Pain Score. Adverse effects were recorded.

EMLA conferred significantly better efficacy than 10% lidocaine (

 < .001). For acceptable pain at 4-mm depth, the minimal application times were 40.88 and 45.38 min of EMLA and 10% lidocaine creams, respectively. With 60/120-min application, the maximal needle-insertion depths with acceptable pain were 6.61/9.47 mm (EMLA) and 6.01/8.94 mm (10% lidocaine). EMLA's anesthetic effect showed an early increase after removal which was sustained for 60-90 min. Both creams caused adverse effects, with EMLA showing higher proportions, although the differences were statistically insignificant.

The efficacy of EMLA was superior to 10% lidocaine cream, especially regarding anesthesia onset and duration.

The efficacy of EMLA was superior to 10% lidocaine cream, especially regarding anesthesia onset and duration.

This study examined a 2-year period following an eating disorder (ED) diagnosis in order to determine patterns of health care utilization.

We conducted a retrospective cohort study of children (n=1560) diagnosed with an ED between 2000 and 2017. The ED diagnosis was made at a tertiary level hospital for children and adolescents presenting for outpatient assessment by specialist adolescent medicine physicians and recorded in a program database over this period of time. We then created three sex- and age-matched comparison cohorts using provincial health administrative databases including a general population cohort, a diabetes cohort (to compare nonmental health care utilization) and a mood disorder cohort (to compare mental health care utilization). Outcomes included hospitalizations, emergency department visits, as well as general practitioner, psychiatrist, and pediatrician visits. Odds ratios (dichotomous outcomes) and rate ratios (continuous outcomes) were calculated.

Compared to the general population cohort, the ED cohort had higher odds and rates of all types of health care utilization.