Hollandhaagensen1369

A 42-year-old woman presented with a severe neck pain and torticollis due to uncertain etiology. Because her radiographs and computed tomography revealed atlantoaxial rotatory fixation (AARF) that is an extremely rare condition in the adult population, a nonsurgical treatment was initially applied. Because 3 weeks of indirect traction failed, closed reduction was performed under general anesthesia at 2 months after onset, and her symptoms markedly improved without any complications and recurrence.

Closed reduction under general anesthesia for nontraumatic AARF in adult patients might be an effective treatment option, even for chronic cases or intractable cases by traction treatment.

Closed reduction under general anesthesia for nontraumatic AARF in adult patients might be an effective treatment option, even for chronic cases or intractable cases by traction treatment.

We present the case of an infant with an amputation from amniotic band syndrome and no other complications. During the seventh week of life, the infant developed severe pain in the affected limb that was ultimately found to be indicative of osteomyelitis.

The infant displayed minimal systemic response, and cultures that grew methicillin-sensitive Staphylococcus aureus were needed to confirm the diagnosis. Surgical debridement, stump revision, and oral antibiotic therapy provided definitive treatment for our patient. selleck The reader is encouraged to consider the possibility of osteomyelitis in similar circumstances.

The infant displayed minimal systemic response, and cultures that grew methicillin-sensitive Staphylococcus aureus were needed to confirm the diagnosis. Surgical debridement, stump revision, and oral antibiotic therapy provided definitive treatment for our patient. The reader is encouraged to consider the possibility of osteomyelitis in similar circumstances.

Three patients (age, 15-34 years) who had a history of chronic traumatic anteroinferior glenohumeral instability (2-10 dislocations) and preoperatively documented Bankart and Hill-Sachs lesions underwent all-arthroscopic trans-subscapular transposition of the long head of the biceps that was fixed on the anteroinferior glenoid using a novel double double-pulley all-suture anchor method that has not been reported previously.

Excellent 12-month clinical and imaging outcomes, with substantial improvements in the Western Ontario Shoulder Index and the Rowe score in the first consecutive patients who underwent this original technical variant of dynamic anterior stabilization and the surgical pearls and pitfalls are described in detail.

Excellent 12-month clinical and imaging outcomes, with substantial improvements in the Western Ontario Shoulder Index and the Rowe score in the first consecutive patients who underwent this original technical variant of dynamic anterior stabilization and the surgical pearls and pitfalls are described in detail.

Transcatheter aortic valve implantation (TAVI) is being increasingly used in patients with longer life expectancy. Data on long‑term outcomes are still limited.

The aim of the study was to assess the clinical outcomes of patients treated with TAVI and identify baseline and procedure‑related factors influencing long‑term survival.

Symptomatic patients with critical aortic stenosis who were inoperable or had high surgical risk were qualified for TAVI. Between August 2012 and December 2017, 248 consecutive patients treated with self ‑expanding Medtronic valve implantation at American Heart of Poland in Bielsko‑Biała were prospectively enrolled. Patients were followed for 30 days after the procedure and subsequently annually. All events were classified according to the Valve Academic Research Consortium‑2 (VARC‑2) criteria and assessed. Survival was compared between the subgroups defined by the EuroSCORE II (European System for Cardiac Operative Risk Evaluation II) and with matched representatives from the l population.

TAVI with a self‑expanding Medtronic valve implantation according to a consistent protocol was associated with favorable outcomes. Patients with lower EuroSCORE II scores had the same prognosis as the actuarial survival of the general population.

Heart rate control in atrial fibrillation (AF) is typically assessed by 24‑hour electrocardiography (ECG). There are scarce data on the use of 24‑hour ECG parameters to predict mortality in patients with AF.

We aimed to identify 24‑hour ECG parameters that predict mortality in patients with AF.

We enrolled 280 ambulatory patients (mean [SD] age, 72 [8.7] years; 57.9% men) with permanent or persistent AF. Data on mortality and pacemaker or defibrillator implantation during follow‑up were collected. Predictors of mortality were assessed using the Cox proportional hazards model and C statistic.

Compared with survivors, 78 patients (28%) who died were older, more often had comorbidities, left bundle branch block (LBBB), reduced left ventricular ejection fraction, lower maximum heart rate, higher number of ventricular extrasystoles, and the longest R‑R interval below 2 seconds. Univariate analysis showed higher mortality in patients with the longest R‑R intervals below 2 seconds compared with those with R‑R intervals of 2 seconds or longer (P <0.001). Independent mortality predictors in the regression model included older age, renal failure, history of coronary intervention, chronic obstructive pulmonary disease, LBBB, and a high number (≥770) or absence of R‑R intervals of at least 2 seconds. The area under the curve for mortality prediction increased after including ECG parameters (0.748; 95% CI, 0.686-0.81; vs 0.688; 95% CI, 0.618-0.758; P = 0.02).

A high number of R‑R intervals longer than 2 seconds or their absence on 24‑hour ECG may predict mortality in patients with AF.

A high number of R‑R intervals longer than 2 seconds or their absence on 24‑hour ECG may predict mortality in patients with AF.Persistent foramen ovale (PFO) is a congenital heart disease which represents 80% of atrial septal defects. It is a remnant of fetal circulation that functions in postnatal conditions as a transient interatrial right‑to‑‑left shunt of variable magnitude. Persistent foramen ovale may be implicated in the pathogenesis of several medical conditions, such as cryptogenic stroke, cryptogenic left circulation thromboembolism, migraine syndromes, and decompression sickness. The most frequent indication for PFO closure remains PFO‑associated left circulation thromboembolism. In select patients, PFO closure reduces stroke recurrence in comparison with medical therapy after more than 3 years of follow‑up on average, especially in patients with a high risk of recurrence. While in PFO‑associated left circulation embolism, there is now conclusive evidence on the growing benefit of PFO closure in long‑term follow‑up, in many other clinical conditions, the degree of certainty of the results is deceiving. In this paper, we will review the benefits and risks that one can expect in the long term after percutaneous PFO closure in various clinical scenarios in order to facilitate therapeutic decision making.