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We describe a case of nosocomial mucormycosis of the thigh in an immunocompromised patient admitted with COVID-19 acute respiratory distress syndrome.
Giant cell tumor (GCT) of bone has a rare potential for metastatic spread. This study aimed at evaluating the incidence of chest metastases in GCT and their oncological outcome and identifying possible risk factors.
Medical records of 466 (313 de novo and 153 recurrent) patients with primary GCT of bone were retrospectively reviewed. Fifteen (3.2%) patients developed chest metastasis. Time from diagnosis of the primary bone lesion to the diagnosis of metastasis, treatment modalities of metastasis, and the course of treatment were revised. The functional outcome was evaluated using the Musculoskeletal Tumor Society (MSTS) scoring system, and postoperative complications were recorded.
This study included 7 males and 8 females with a mean age of 27.3±7.9 years. The most common site of the primary tumor was the distal femur. All fifteen patients were recurrent cases. The mean follow-up period was 67.7±33.2 months. Chest metastasis was diagnosed after a mean time of 28.1±28.9 months from the initial diagnosis of the bone lesion. One patient died of disease (DOD) 18 months after the surgical intervention. The incidence of chest metastasis in recurrent cases was 9.8%, while de novo cases did not develop chest metastasis, P<0.001. Previous curettage was associated with a higher incidence of chest metastasis (14.6%) compared to previous resection (4.2%), P=0.03.
Chest metastasis following GCT of bone is rare. Risk factors include recurrent cases, especially following previous curettage. Patients have a good prognosis and a low mortality rate.
Level IV, retrospective.
Level IV, retrospective.Ultrasonography and magnetic resonance imaging have become important imaging modalities in rheumatological disorders next to standard radiography. Due to their ability to assess both morphological and functional changes they play a significant role in early diagnosis and treatment monitoring. selleck compound This review presents the latest advancements in imaging of inflammatory arthritis with a focus on two main groups of rheumatic diseases connective tissue diseases and spondyloarthritis. New developments related to peripheral and sacroiliac joints imaging are discussed, including Superb Micro Flow Imaging and Shear Wave Elastography in ultrasonography, as well as Whole Body MRI, quantitative MRI, and the recent advances in cartilage imaging in MRI, including T2-and T1p-mapping, and dGEMRIC. The role of emerging imaging techniques in the early diagnosis of inflammatory arthritis is discussed, including DECT, VIBE, BoneMRI, and pQCT.
Patellar instability is a painful condition which affects the quality of life and mobility of young individuals. The aim of this study is to observe the results of medial patello-femoral ligament reconstruction with hamstring autograft along with a modified Fulkerson osteotomy, for recurrent instability of patella with high-grade trochlear dysplasia in Indian population.
We conducted a prospective observational study of 26 knees (21 patients) who attended our outpatient department from June 2014 to February 2019, with recurrent instability of the patella and high-grade trochlear dysplasia. All knees were treated with MPFL reconstruction with hamstring autograft and modified Fulkerson osteotomy.
The mean follow-up period was 30 months (range 24-50). The mean Lysholm scores improved from 49.9 (range 30-63) preoperatively to 82.5 (range 51-100) (p<0.05), Kujala scores from 55.5 (36-67) to 85.9 (55-100) and International Knee Documentation Committee (IKDC) scores from 50.2 (31.6-62.3) to 82.9 (54.7-98.3) (p<0.05) at 2 years follow-up. TT-TG distance decreased from 21.2mm (18-25) to 11.6mm (10-13) (p<0.05) and patellar tilt angle decreased from 24.2° (18°-35°) to 7.2° (5°-10°) (p<0.05). One knee had superficial skin infection in immediate post-operative period. Three knees had postoperative stiffness, which improved on manipulation under anesthesia. Six knees had implant irritation from the osteotomy screws which were removed after bony union was achieved. Functional scores were low in two knees due to patello-femoral pain, but they did not have recurrent instability.
MPFL reconstruction with tibial tubercle transfer gives good functional outcomes in 92.3% patients with recurrent patellar instability, associated with high-grade trochlear dysplasia in Indian population.
MPFL reconstruction with tibial tubercle transfer gives good functional outcomes in 92.3% patients with recurrent patellar instability, associated with high-grade trochlear dysplasia in Indian population.Implemented quarantine due to the ongoing novel coronavirus (agent of COVID-19) has an immense impact on human mobility and economic activities as well as on air quality. Since then, and due to the drastic reduction in pollution levels in cities across the world, a large discussion has been magnetized regarding if the lockdown is an adequate alternative counter-measure for enhancing air quality. This paper aimed at studying the Air Quality Index (AQI), PM2.5, and tropospheric NO2 levels in three lockdown phases (before, during, and after) among 21 cities around the world. Simple before/after comparison approach was carried out to capture the declining trend in air pollution levels caused by the lockdown restrictions. The results showed that the frequency distribution for NO2 is more variable than that for PM2.5, and the distribution is flatter from 2020 to the baseline 2018-2019 period. Besides, AQI, in most of the cities, has varied from high to mild pollution during the lockdown and was moderate before. Although during the lockdown, a reduction of 3 to 58% of daily NO2 concentrations was observed across the cities, an increase was detected in three cities including Abidjan (1%), Conakry (3%), and Chengdu (10%). Despite this mixed trend, the NO2 time series clearly showed the effect of the unlocking phase where the NO2 levels increased in almost all cities. Similarly, PM2.5 concentrations have increased in the post-lockdown period, with 50% of the cities reporting significant positive differences between the lock and the unlock phase. Then, the levels of PM2.5 were higher at the pre-lockdown phase than at any other time exhibiting a "U" shape. In addition, during Ramadan, it was noted that altered patterns of daily activities in some Islamic cities have a significant negative impact on air quality.
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