Hillstanley4784

Background Young patients with symptomatic chondral defects in the medial compartment with varus malalignment may undergo opening wedge high tibial osteotomy (HTO) with concomitant osteochondral allograft transplantation (OCA) (HTO + OCA). Although patients have demonstrated favorable outcomes after HTO + OCA, limited information is available regarding return to sporting activities after this procedure. Purpose To evaluate (1) the timeline to return to sports (RTS), (2) patient satisfaction, and (3) reasons for discontinuing sporting activity after HTO + OCA, and to identify predictive factors of RTS. Study design Case series; level of evidence, 4. Methods Consecutive patients who underwent HTO + OCA for varus deformity and medial femoral condyle focal chondral defects with a minimum 2-year follow-up were retrospectively reviewed. Patients completed a subjective sports questionnaire, satisfaction questionnaire, visual analog scale for pain, and Single Assessment Numerical Evaluation. Results Twenty-eight pati postoperative expectations regarding sports participation after HTO + OCA.Objective The objective of this study was to determine the prevalence and spectrum of pathology of the fascia lata attachment at the iliac crest (FLAIC) on MRI in asymptomatic patients in order to refine our diagnostic criteria for clinically relevant FLAIC injury. Methods and material Two readers retrospectively evaluated the FLAIC on each side on coronal large field-of-view short tau inversion recovery images on 100 musculoskeletal pelvic MRI exams performed in patients without hip pain (total n = 200). Pathology of the FLAIC was graded using a 3-point Likert scale and discrepancies were resolved by consensus. Results Of the 200 FLAIC included in the study, 72.5% demonstrated normal size and signal intensity. Low to moderate grade pathology of the FLAIC was identified in 27% and high-grade partial thickness pathology was seen in 0.5%. No cases of complete FLAIC rupture were identified. Inter rater agreement between the two readers was good (k=0.660, p less then 0.001). selleck chemicals llc There was no statistical difference in FLAIC scores according to gender or age. FLAIC score was positively correlated with higher body mass index. Conclusion Incidental low to moderate grade FLAIC pathology is commonly seen on MRI in asymptomatic patients. Abnormal MRI findings of the FLAIC should hence be correlated with explicit clinical symptoms and physical exam findings. Advances in knowledge The Fascia lata is a complex anatomic structure. Its attachment to the iliac crest is an under recognized pathology and sometimes overlooked during evaluation for pelvis and lateral hip pain. Evaluation of the FLAIC is easily done with MRI and abnormality should be correlated to the clinical symptomatology as low grade abnormality is frequently seen in asymptomatic population.Introduction Age related neurodegenerative disorders affect millions of people around the world. The role of the gut microbiome (GM) in neurodegenerative disorders has been elucidated over the past few years. Dysbiosis of the gut microbiome ultimately results in neurodegeneration. However, the gut microbiome can be modulated to promote neuro-resilience. Areas covered This review is focused on demonstrating the role of the gut microbiome in host physiology in Parkinson's disease (PD) and other neurodegenerative disorders. We will discuss how the microbiome will impact neurodegeneration in PD, Alzheimer's Disease (AD), Multiple sclerosis (MS), Amyotrophic Lateral Sclerosis (ALS), and finally discuss how the gut microbiome can be influenced through diet and lifestyle. Expert opinion Currently, much of the focus has been to study the mechanisms by which the microbiome induces neuroinflammation and neurodegeneration in PD, AD, MS, ALS. In particular, the role of certain dietary flavonoids in regulation of gut microbiome to promote neuro-resilience. Polyphenol prebiotics delivered in combination with probiotics (synbiotics) present an exciting new avenue to harness the microbiome to attenuate immune inflammatory responses which ultimately may influence brain cascades associated with promotion of neurodegeneration across the lifespan.Introduction Right ventricular outflow tract (RVOT) dysfunction is common among individuals with congenital heart disease (CHD). Surgical intervention often carries prohibitive risks due to the need for sequential pulmonary valve (PV) replacements throughout their life in the majority of cases. Transcatheter pulmonary valve replacement (tPVR) is one of the most exciting recent developments in the treatment of CHD and has evolved to become an attractive alternative to surgery in patients with RVOT dysfunction. Areas covered In this review, we examine the pathophysiology of RVOT dysfunction, indications for tPVR, and the procedural aspect. Advancements in clinical application and valve technology will also be covered. Expert opinion tPVR is widely accepted as an alternative to surgery to address RVOT dysfunction, but still significant numbers of patients with complex RVOT morphology deemed not suitable for tPVR. As the technology continues to evolve, new percutaneous valves will allow such complex RVOT patient to benefit from tPVR.D-dimer testing combined with a clinical assessment has become a standard pathway for ruling-out venous thromboembolism (VTE). Recently, novel Point-of-Care (POC) D-dimer assays have been introduced, enabling low-volume blood sampling for rapid exclusion of VTE in a one-step procedure. We assessed the analytical validity and user-friendliness of a set of these novel POC D-dimer assays, and compared the results with a standard laboratory assay. Plasma samples were run on our reference assay (STA-Liatest D-di PLUS®) and five POC assays Nano-Checker 710®, AFIAS-1®; iChroma-II®; Standard F200® and Hipro AFS/1®). After evaluating imprecision, Pearson Product-Moment correlation coefficients were calculated, Passing Bablok regression was performed and Bland-Altman plots were generated. User-friendliness was evaluated using the System Usability Scale (SUS). A set of 238 plasma samples of patients clinically suspected of VTE in general practice was available for analysis. Only one POC D-dimer assay (Nano-Checker 710) demonstrated an insufficient degree of imprecision.