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Handberg posted an update 10 months, 3 weeks ago
A 22-year-old female presented with painful, progressive swelling of the right forearm for six months. Physical examination revealed a 7 cm x 5 cm firm, tender soft-tissue swelling over the anterior aspect of the right proximal forearm with normal overlying temperature. X-rays showed increased soft tissue shadow but without any bony involvement. Serum alkaline phosphatase, serum lactate dehydrogenase, and leukocyte count were raised. MRI of the right forearm revealed enhancing soft tissue lesion with internal hemorrhagic and necrotic components involving the flexor carpi radialis muscle. Core biopsy confirmed the diagnosis of extraosseus Ewing’s sarcoma. Neoadjuvant chemotherapy, wide local tumor excision, and adjuvant chemotherapy and radiotherapy were done. The patient then lost to follow-up and presented again after six months with a fungating mass and neurovascular involvement for which an above-elbow amputation was done. We, through this case report, aim to discuss the clinical and radiological findings, line of management, and the importance of early detection and treatment and a regular follow-up for extraosseus Ewing’s sarcoma of the extremity.
Scholarly activity is a major component of residency training and the accreditation process for graduate medical education. In 2014, Accreditation Council for Graduate Medical Educationand the American Association of Colleges of Osteopathic Medicineannounced a single accreditation system with the transition beginning July 1, 2015. Previous data before the transition had shown that osteopathic physicians rarely published original research in three high-impact pediatric journals.The objective of this study is to determine if there is a degree disparity between osteopathic and allopathic physicians among authors who publish original research manuscripts in three high-impact pediatric journals after the beginning of the transition to a single graduate medical education accreditation system. Methods Degree designation for the first and senior authors of original research manuscripts was reviewed for theJournal of Pediatrics (J Pediatr), Pediatrics, andJAMA Pediatrics (JAMA Pediatr)for the years2016, 2017, 2018, and 2019. Inter-rater reliability was calculated by thekappa coefficient, and data were analyzed with descriptive statistics and simple linear regression. PF-3644022 price Results A total of 3,252 manuscripts and 4,068authors were reviewed with0.98%of all authors being osteopathic physicians. A total of1.65%of first authors and0.41%of senior authors were osteopathic physicians. For those with a dual degree, a total of1.03%of first, and 0.41% of senior authors were osteopathic physicians. No statistical trend could be established for increased first, senior, dual-degree first, or dual-degree senior osteopathic physician authorship.
Osteopathic physicians continue to be underrepresented as first and senior authors in original publications in the three high-impact pediatric journals as compared to their allopathic counterparts.
Osteopathic physicians continue to be underrepresented as first and senior authors in original publications in the three high-impact pediatric journals as compared to their allopathic counterparts.Total Hip replacement (THR) is a well-discussed topic, and it offers excellent results in patients suffering from end-stage osteoarthritis (OA). However, despite the fact that patients can fully bear weight immediately after the surgery, THR is often associated with a great amount of postoperative pain affecting recovery and rehabilitation. Therefore, the efficient management of pain is of paramount importance. The aim of this review is to examine all the currently available strategies of pain management such as preemptive analgesia (PA), patient-controlled analgesia (PCA), and the various types of anesthesia that are used during the operation. With that objective in mind, we conducted our research by searching through the PubMed database for articles published in 2015 and after. For purely clinical reasons, we have attempted to classify all the best available evidence into three major categories prior to surgery, during the surgery, and after the surgery. Multimodal analgesia seems to play a major role in the perioperative care of patients undergoing total hip arthroplasty (THA). Therefore, a considerable number of studies have been conducted analyzing all the current strategies that aim to minimize perioperative pain and consequent complications.In the world scenario, the advent of COVID-19 has halted every aspect of life. It influenced every field of life, including the economy, and revealed the inadequacies in all nations’ healthcare systems, from the most developed to the underdeveloped countries. There is a debate about the timing of antibodies production and detection during the disease. What is the significance of reverse transcription-polymerase chain reaction (RT-PCR) viral ribonucleic acid (RNA) in symptom resolving period? In the present manuscript, we have evaluated these points.Background Negative pressure wound therapy (NPWT) with instillation and dwell time (NPWTi-d) includes periodic instillation of topical solution into the wound followed by a negative pressure. Our objective was to evaluate potential differences in wound outcomes in patients receiving NPWT and those receiving NPWTi-d using saline. Methods An analysis was performed using two previously published independent studies from a single investigator and hospital to compare patient characteristics and clinical outcomes of infected wounds from 74 NPWT-treated patients with 42 NPWTi-d-treated patients. Results Patient demographics and comorbidities, wound etiologies, and anatomical locations of wounds were similar between groups, although a significantly higher percentage of NPWT-treated patients had end-stage renal disease (P = 0.0119). Compared with patients treated with standard NPWT, NPWTi-d-treated patients had a significantly lower number of operations (P = 0.0048), shorter length of hospital stay (P = 0.0443), shorter time to final surgical procedure (P = 0.0001), higher percentage of closed wounds (P = 0.0004), and a higher percentage of wounds that remained closed at one month (P = 0.0001). Conclusions The results of this analysis suggest that management of infected wounds with NPWTi-d using saline leads to favorable wound outcomes when compared to those managed with NPWT.