According to a randomized trial that included more than 160 patients, patients with knee osteoarthritis who wear stable supportive shoes for 6 months have greater average reductions in knee pain when walking, compared with patients who wear flat flexible shoes. Abnormal knee joint loading has been implicated in the pathogenesis of knee OA. Guidelines recommend that patients wear appropriate footwear, but research has not established which shoes are best.
Journal Abstracts
The meta-analysis carried out by Suetonia C Palmer et al. aimed to determine the effect of sodium-glucose cotransporter-2 (SGLT-2) inhibitors and glucagon-like peptide-1 (GLP-1) receptor agonists in patients with type 2 diabetes. The study included an analysis of 764 randomised control trials and found that both classes of drugs lowered all cause mortality, cardiovascular mortality, non-fatal myocardial infarction, and kidney failure. SGLT-2 inhibitors were found to reduce mortality and hospital admission for heart failure whereas GLP-1 receptor agonists reduced non-fatal stroke.
Recent Articles
Ilene Tisnovsky et.al. conducted a study to propose a gunshot wound-related hip injury algorithm and improve patient outcomes. The researchers concluded that various therapeutic strategies have been used for the management of gunshot wound-related hip injuries but further prospective studies are necessary to determine the optimal therapeutic modality.
Pauline Besonhe et.al. presented a case of a newborn in which surgery was necessary to free both fingers and toes from constrictive bands responsible for ischemia. In the absence of surgery, the constrictive bands can lead to amputation (pseudoainhum). The purpose of this case report is to expose the management and the role of an orthopaedic surgeon in the treatment of a collodion baby.
T2DM patients who have been on metformin therapy is found to benefit from the drug in that metformin is associated with a threefold decrease in mortality due to COVID-19. The exact mechanism behind this beneficial effect is unknown but it could be attributed to the anti-inflammatory and anti-thrombotic effects of the drug. A mortality rate of 11 percent was observed among metformin users as opposed to the 23 percent among nonusers, pointing to the possibility of a protective effect the drug might impart to diabetic patients.
Clinical Research
The purpose of this study is to find the most effective dose of radiation therapy to give to breast tumors in a shorter period of time, prior to standard partial mastectomy/axillary surgery.
This research study is being done to understand how patients with chronic cancer pain take their long-acting opioid medications and to develop an intervention to enhance cancer pain management.
Christopher G. Brennan-Jones et.al. identified specific strategies which have shown effectiveness in reducing workplace noise. These include implementation of stricter legislation and also stress upon the need for training in the proper use of earplugs and earmuffs so as to reduce noise exposure to safe levels.
Publications
Recent evidence that SARS-CoV-2 vaccine is associated with inflammatory reactions in patients with dermal fillers has led the American Society for Dermatologic Surgery to issue a guidance outlining the potential risk and clinical relevance. Of a total of 15,184 participants who received at least one dose of mRNA-1273, three developed facial or lip swelling that was presumably related to dermal filler. In the placebo group, there were no comparable inflammatory events.
In patients with previously untreated chronic lymphocytic leukemia (CLL) or small lymphocytic lymphoma (SLL), a once-daily oral regimen of ibrutinib and venetoclax was associated with deep molecular remissions in both bone marrow and peripheral blood, including in patients with high-risk disease, according to investigators in phase 2 CAPTIVATE MRD trial.
Georgios Tsakonas et.al. conducted a study to understand the alterations in gene expression in brain metastasis versus primary tumour as it may increase aggressiveness and impair therapeutic efforts. The researchers concluded identified a unique gene downregulation pattern in brain metastases compared with primary tumours. This finding may explain the lower intracranial efficacy of systemic therapy, especially immunotherapy, in brain metastasis of patients with non–small-cell lung cancer.
Videos
A 30-year-old female presented with rapid onset of acute dysarthria and left oculomotor paralysis. The MRI showed ruptured anterior midbrain cavernoma. A conservative approach was adopted as the patient was stable. However, one month later she experienced a new bleed with right hemiparesis, diplopia and severe dysarthria. The haemorrhage extended to the surface of the midbrain anteriorly and extended posteriorly without reaching the surface of the safe entry zone. The approach to a cavernous malformation via safe zones are not always feasible due to the proximity of several critical neural structures as in this case. The resection via a posterolateral route using the supracerebellar infratentorial approach was performed successfully.
A 30-year-old female presented with rapid onset of acute dysarthria and left oculomotor paralysis. The MRI showed ruptured anterior midbrain cavernoma. A conservative approach was adopted as the patient was stable. However, one month later she experienced a new bleed with right hemiparesis, diplopia and severe dysarthria. The haemorrhage extended to the surface of the midbrain anteriorly and extended posteriorly without reaching the surface of the safe entry zone. The approach to a cavernous malformation via safe zones are not always feasible due to the proximity of several critical neural structures as in this case. The resection via a posterolateral route using the supracerebellar infratentorial approach was performed successfully.
As many as half of patients diagnosed with metastatic HER2-positive breast cancer will see their cancer spread to their brain. Though brain metastases, or "Brain Mets," are rare, they are exceedingly difficult to treat, so these patients experience poor outcomes. At this year’s ASCO meeting, Dr. Nancy Lin of Dana-Farber Cancer Institute presented promising results from the HER2CLIMB trial for these patients. In this video BCRF talks with Dr. Lin about her research focus, Brain Mets, and HER2CLIMB’s findings.
Watch Dr. Jamie Studts discuss the quality implementation of lung cancer screening and share his thoughts on optimizing community-based implementation.
Case Studies
Pauline Besonhe et.al. presented a case of a newborn in which surgery was necessary to free both fingers and toes from constrictive bands responsible for ischemia. In the absence of surgery, the constrictive bands can lead to amputation (pseudoainhum). The purpose of this case report is to expose the management and the role of an orthopaedic surgeon in the treatment of a collodion baby.
Morika Suzuki et al. report the case of a 55-year-old man who presented with fever and dysuria. Subsequent to his hospital admission he showed urinary retention and later on developed involuntary movements of the extremities, nuchal rigidity, hyperreflexia of the deep tendon reflexes, and pathological reflexes in the bilateral lower extremities. Lumbar puncture revealed elevated cerebrospinal pressure, protein count and cell count with dominant mononuclear cells. Based on the findings a diagnosis of urinary retention due to meningitis-retention syndrome (MRS) with aseptic meningitis was made. A positive polymerase chain reaction test for Epstein–Barr virus led to the identification of EBV reactivation as the cause of MRS.
Michael Agustin et.al. presented a case of a case of spontaneous left-side chylothorax following septic pulmonary embolization with Methicillin-Resistant Staphylococcus aureus. This is a rare case of a nonmalignant, nontraumatic, and nontuberculous spontaneous chylothorax which was conservatively treated with fibrinolysis and diet modification.
Muhammad Umar Shahzad et al. report the uncommon presentation of tension pneumothorax in a 62-year-old man who came into the ER with dry cough, low grade fever, shortness of breath, and chest pain. The patient gave a history of T2DM, PVD, treated malignant neoplasm of the base of the tongue, diverticular disease, essential hypertension, and previous provoked pulmonary embolism. CTPA revealed right upper lobe consolidation with subtle peripheral ground glass opacification in the left upper lobe and both lower lobes and his swab came in positive for SARS-CoV-2. Following the deterioration of his condition a chest X-ray was done which demonstrated a large right-sided pneumothorax.