Current Issue : October - December Volume : 2020 Issue Number : 4 Articles : 5 Articles
Background: Bone marrow lesions (BMLs) are a common finding in patients with osteoarthritis (OA), which are\npredictors of progression and pain related to cartilage damage in OA. The objective of the present research was to\ncompare the short-term clinical effect of intramuscular calcitonin and oral celecoxib in treating knee BMLs.\nPatients and methods: Between January 2016 and December 2018, the medical records of patients with knee\nBMLs treated by intramuscular calcitonin or oral celecoxib were reviewed. Visual analog scale (VAS) and the Western\nOntario and McMaster University Osteoarthritis Index (WOMAC) were used to assess knee pain and function,\nrespectively. BMLs were assessed by MRI scans and were scored by the modified Whole-Organ MRI Score (WORMS).\nThe safety of these two medications was also evaluated.\nResults: A total of 123 eligible patients who received calcitonin treatment.................
The purpose of this research is to evaluate clinical and cost effectiveness of\ntotal knee replacement surgery (TKA) for adults hospitalized in the United\nStates between 2010 and 2013. We tried to answer the question that whether\nlower length of stay and higher utilization of post-op facilities would be helpful\nto control the overall costs. Using the National Hospital Discharge Survey\n(NHDS) database and cost data from Blue Cross Blue shield, this study seeks\nto identify which U.S. region renders the highest quality patient care during a\nthree-year span of 2008-2010. Using length of stay and discharge disposition\n(2010) as input factors, and regional TKA costs (2013) as output factors, Data\nEnvelopment Analysis (DEA), a non-parametric method, illustrated the efficiency\nranking of four regions in the US on TKA expenditures. The result shows\nthe West is the most efficient region on controlling the overall cost by shrinking\nthe length of stay and increasing the utilization of short-term/long-term care\nfacilities....
Background: Nodular fasciitis (NF) is currently considered a self-limited\nclonal neoplastic process. It shares the rearrangement of USP6-gene with\naneurysmal bone cysts and myositis ossificans. The presented case is of interest\nas this is a rare site of presentation of NF; so far only few single cases of\nintraarticular NF have been reported with documented USP6-gene rearrangement.\nIntraarticular neoplasias of the knee joint are rare; the most frequent\nbeing tenosynovial giant cell tumor (TSGCT). Given a nationwide annual incidence\nrate of 14 for the lower extremity and about 75% affecting the knee\njoint about 10 new cases involving the knee joint can be expected per 1 million\npersons/year. All other types of benign neoplasms are comparably rare\nwhile malignant intraarticular processes are extremely rare with most of them\nreported as single case studies. Aim: We report our case to emphasize the\nimportance of preoperative diagnostics including the option of biopsy. Intraarticular\nmalignant processes are extremely rare and frequently are operated\non accidently with negative consequences for the patient. Tactics and techniques\nto treat benign processes depend on the correct pathologic diagnosis.\nCase presentation: The 38 year old man noticed slowly increasing swelling of\nhis left knee joint after wakeboarding. Because of continuing discomfort 2\nmonths later MRI diagnostic revealed, apart from retropatellar cartilage lesions,\na popliteal mass compatible with a Baker cyst. The lesion of interest\n(later diagnosed as NF) was neither recognized by the radiologist nor the\ntreating clinician. During the following 8 months the patient felt increasing\nswelling of the knee joint. The repeat MRI documented the crescent intraarticular\nsolid synovial mass in the medial patellofemoral recess without signs\nof hemosiderin impregnation. A percutaneous sonographically guided 16G\nneedle biopsy was performed. Histologically, bland myofibroblastic proliferation\nsuggestive of nodular fasciitis (NF) was found. The next generation sequencing\n(NGS) demonstrated the presence of MYH9-USP6 gene fusion,\nconfirming the diagnosis of NF. The lesion was excised under arthroscopic\ncontrol. At 1 year follow-up the patient is asymptomatic. Conclusion: The\ncase is of interest because of its rare pathology. The decision how to treat was\nbased on pathologic biopsy diagnostics including the USP6-gene rearrangement.\nIn view of similar presentation of the rare malignancies we also want to\nstress the importance of definitive diagnostics which generally are possible\nonly through biopsy....
Rheumatoid Arthritis (RA) is an inflammatory disease associated with high\nmorbidity and increased cardiovascular disease, and Metabolic Syndrome\n(MS) is understood as a set of metabolic disorders that correlates with obesity\nand sedentary lifestyle. The aim of this study is to evaluate the prevalence of\nMS in a cohort of patients with RA and its correlation to specific factors of\nthe disease. A retrospective cohort study was conducted with 283 patients\nwith RA, followed at the Rheumatology Outpatient Clinic of the Hospital de\nClÃnicas de Porto Alegre (HCPA) between 2008 and 2016; 187 continued to\nbe followed and agreed to be reevaluated between January and November\n2016. MS was defined according to the National Cholesterol Education Program\nand disease activity was assessed using the Disease Activity Score (DAS28).\nClinical, biochemical, and anthropometric evaluations were conducted. The\nprevalence of MS in the first evaluation was 43.9% and, after 8 years, 59.4%.\nIncreased waist circumference and blood pressures, elevated triglycerides and\nlow High-Density Lipoprotein were the most frequent features of MS. The\nDAS28 was significantly lower in the reevaluation..............................
Main intention of the research is to understand about significance of techniques\nassociated with HTO. This research reviewed the techniques of high\ntibial osteotomy namely high tibial osteotomy, open wedge high tibial osteotomy,\nclosedhigh tibial osteotomy. Patients who are suffering from knee arthritis,\nhigh tibial osteotomy assists to prevent or delay the requirement for\ntotal or partial replacement of knee to preserve damaged tissue of joint. High\ntibial osteotomy technique is mainly suitable for active and young patients with\nknee osteoarthritis. Age plays a main factor in success rate of high tibial osteotomy\ntechnique. It could be done in open wedge or closed wedge high tibial\nosteotomy. For some cases, surgery could be done in combined method (open\nwedge and closed wedge high tibial osteotomy). When compared with clinical\noutcomes of closed wedge high tibial osteotomy and open wedge high tibial\nosteotomy, open wedge high tibial osteotomy performs well in reducing the\npain, duration of weight-bearing and return to normal life as soon as possible....
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