Part One: Tapping the Wrist
The wrist is not commonly aspirated in the emergency department, but emergent arthrocentesis may be indicated for extreme or concerning cases, and tapping the wrist to determine the underlying pathology or relieve pain may be of great value. The synovial fluid from the joint space can be analyzed for crystals, infection, and blood. This information may help determine the overall plan and aid in decision-making and consultation. The ultimate treatment plan may include admission, intravenous antibiotics, multiple aspirations, and even surgical washout.A swollen, painful wrist that is hot to the touch is concerning for septic arthritis. Use ultrasound to confirm the proper aspiration site and the angle for the needle during arthrocentesis. This patient had multiple bandages on his fingertips from blood glucose testing, providing an entry for infection and increasing the chance of developing a septic joint.Joint aspirations carry minimal risk when done properly. They may even have lower morbidity and mortality than those who undergo surgical debridement. (J Bone Joint Surg Am. 2015;97:558; http://bit.ly/2SVs7Dc.) The wrist is complex, and our video highlights the anatomy using ultrasound (US). We suggest a static approach to determine if there is a collection of fluid or an abscess, and then consider US-guided needle aspiration of the joint.Watch a video of Walter Schlech, MD, the ultrasound director at Berkshire Medical Center in Pittsfield, MA, using ultrasound to identif...
CONCLUSION: In hypertensive and diabetic patients, higher OPG values were associated with impaired LA function assessed by 2D-STE. In this high-risk patient group, serum OPG can be used as a risk predictor for LA mechanical dysfunction. PMID: 32462219 [PubMed - as supplied by publisher]
Publication date: Available online 29 May 2020Source: Biochimica et Biophysica Acta (BBA) - Proteins and ProteomicsAuthor(s): Khushdeep Bandesh, Dwaipayan Bharadwaj
Uterine fibroids (leiomyoma) are benign monoclonal neoplasms of the myometrium and represent the most common tumors in women worldwide. Tumors occur in ∼77% of women overall and are clinically manifest in ∼25% by age 45 years. Although benign, these tumors are nonetheless associated with significant morbidity; they are the primary indication for hysterectomy, and a major source of gynecologic and reproductive dysfunction, ranging from profuse m enstrual bleeding and pelvic pain to infertility, recurrent miscarriage, and preterm labor.
Effect of unsymmetrical oligo-phenylene-ethynylene OPE3 against multidrug-resistant bacteria in vitro and in vivo. J Chemother. 2020 May 28;:1-9 Authors: Yuan Q, Wang Y, Yao P, Lv J, Wang Q, Sun F, Feng W Abstract The rapid proliferation of multidrug-resistant (MDR) bacterial infections has posed the serious health threats. Photodynamic therapy is considered one of the most promising therapeutic strategies for combating bacterial resistance. In the present study, we synthesized an unsymmetrical oligo-p-phenylene ethynylene (OPE), namely OPE3, and investigated its antimicrobial activity agains...
Authors: Lee J, Kim Y, Mun J, Lee J, Ko S Abstract Background: The present study was designed to evaluate the effects of hypercarbia on arterial oxygenation during one-lung ventilation (OLV). Methods: Fifty adult patients undergoing elective video-assisted thoracoscopic lobectomy or pneumonectomy were enrolled. Group 1 patients (n = 25) were first maintained in normocarbia (PaCO2: 38 - 42 mmHg) for 30 min and then in hypercarbia (45 - 50 mmHg). In group 2 patients (n = 25), PaCO2 was maintained in the reverse order. Arterial oxygen partial pressure (PaO2), respiratory variables, hemodynamic variables, and hemog...
Authors: Singh A PMID: 32460464 [PubMed - as supplied by publisher]
ConclusionThis video demonstrates a form to extract a displaced gastric clip used to create a calibrated tubular gastroplasty using a laparoscopic approach.
Publication date: Available online 28 May 2020Source: The Egyptian RheumatologistAuthor(s): Rasha M. Fawzy, Gamal A. Hammad, Samy E. Egila, Amira N. Elkasas, Nehad A. Fouad
PMID: 32463110 [PubMed - in process]
Conclusions: Serum sST2 is a novel biomarker associated with adverse clinical outcomes in MHD patients. It was significant for both all-cause and cardiovascular mortality in MHD patients and may provide better prognostic value in short-term prognosis than the classic biomarker NT-proBNP. PMID: 32460670 [PubMed - in process]
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