• Richards Stilling posted an update 6 months ago

    Purpose The purpose of this clinical study was to evaluate and compare the effectiveness of ultrasound (US)-guided platelet-rich plasma (PRP) injections versus US-guided corticosteroid injections (CSI) in the treatment of greater trochanteric pain syndrome (GTPS). Methods Between January 2015 and December 2016, 24 patients with GTPS were enrolled and randomized in two groups (A and B). Group A (study group) patients received US-guided PRP injection treatment, while group B (control group) patients received US-guided CSI treatment. Clinical outcomes in both groups were evaluated and compared using the Visual Analogue Scale (VAS) of pain, the Harris Hip Score (HHS) and the presence or absence of complications at 4, 12, and 24 weeks post-injection. The level of significance was set at p less then 0.05. Results Both groups showed improved scores (VAS and HHS) compared to the pre-injection period, but patients in group A had a statistically significant (p less then 0.05) decrease in VAS score and a significantly increased HHS at the last follow-up (24 weeks post-injection). No complications were reported. Conclusions In conclusion, patients with GTPS present better and longer-lasting clinical results when treated with US-guided PRP injections compared to those with CSI. Further studies are needed to optimize the technical preparation of PRP, the sample concentration, the number of injections and the time intervals between them, in order to achieve the maximum desired results. Copyright © 2020, Begkas et al.Giant adrenal myelolipoma is a rare, benign, sizable, mesenchymal tumor. Preoperative differential diagnosis from retroperitoneal liposarcoma may be challenging. A 66-year-old female patient was admitted because of a sizable tumor at the right retroperitoneal space, incidentally discovered during abdominal ultrasonography for screening purpose. Preoperative imaging studies were indicative for the diagnosis of a giant adrenal myelolipoma (11.7 × 12.9 cm in size); however, a retroperitoneal liposarcoma could not be excluded. We decided to proceed with tumor’s surgical removal by using laparoscopic transperitoneal approach and three-dimensional high-definition camera. Intraoperatively, the tumor did not infiltrate surrounding tissues and was surrounded by a thin capsule under which there were sparse, orange-colored spots that resembled adrenal cortex. This finding reinforced the initial and most possible diagnosis of adrenal myelolipoma and we easily enucleated the mass. Postoperative course was uneventful, and the patient demonstrated no recurrence on imaging six months postoperatively. Histology confirmed the diagnosis of giant adrenal myelolipoma, measuring 16.5 x 15 x 6.5 cm. Copyright © 2020, Katsimantas et al.Eosinophilic fasciitis (EF) is an uncommon disease of unknown etiology and is characterized by inflammation and thickening of the muscular fascia and subcutaneous tissue. The patients often have peripheral eosinophilia, increased erythrocyte sedimentation rate, and hypergammaglobulinemia. https://www.selleckchem.com/products/vacuolin-1.html In EF, the skin of the hands and feet are generally spared. Herein we present a case of EF of the wrists with a positive prayer sign and good response to corticosteroid and methotrexate. It is important to emphasize that a positive prayer sign might be the first symptom of EF. The combination regimen of systemic corticosteroids and methotrexate is recommended. Copyright © 2020, Li et al.Metastatic renal cell cancer is treated with systemic therapy, and cytoreductive nephrectomy can be offered in selected patients. The systemic therapy treatment options for kidney cancer have now expanded to include tyrosine kinase inhibitors, monoclonal antibodies, immunotherapy, and combinations thereof. Cytoreductive nephrectomy is considered a safe surgery in most patients. Patients with advanced kidney cancer are known to develop several paraneoplastic syndromes and malignant cachexia. We present the case of a patient with renal cell cancer who was treated with tyrosine kinase inhibitors and despite treatment her disease progressed with subsequent increase in the renal cancer, which led to the development of a fistula between the renal mass and the stomach. Copyright © 2020, Tam et al.Introduction Adrenal incidentalomas (AI) are adrenal masses that are discovered during radiological examinations conducted for other reasons. In this study, we focused on the pathological and radiological properties of nonfunctional AI(NFAI) and the association with malignancy risk in our clinical series. Methods A total of 186 patients underwent adrenalectomy between 2010 and 2017; of these, 76 (40.8%) patients with non-functional AI were included in the current study. The radiological and pathologic characteristics of these AIs were retrospectively analyzed to determine the malignancy rate. Results There were 22 (28.9%) male and 54 (71.1%) female patients with nonfunctional AI included in this study. The median age was 55 (range 24-85) years. Of the patients included, 37 (48.6%) had AI on the left and 39 (51.3%) had AI on the right adrenal gland. Sixty-one (80.2%) cases were treated laparoscopically, four (5.3%) required conversion to open surgery due to intraoperative difficulties such as bleeding and adhesions, and 11 (14.4%) were managed with open adrenalectomy. The rate of malignancy in the tumors with diameters of 6 cm was found to be 0%, 2.9%, and 13.6%, respectively. Conclusions Determining the ideal cutoff value for surgical indication in an NFAI is challenging. Besides the malignancy risk, the rate of silent pheochromacytomas must be taken into account in the surgical decision. Copyright © 2020, Vural et al.This study evaluated a web-based auditory map prototype built utilizing conventions found in audio games and presents findings from a set of tasks participants performed with the prototype. The prototype allowed participants to use their own computer and screen reader, contrary to most studies, which restrict use to a single platform and a self-voicing feature (providing a voice that talks by default). There were three major findings from the tasks the interface was extremely easy to learn and navigate, participants all had unique navigational styles and preferred using their own screen reader, and participants needed user interface features that made it easier to understand and answer questions about spatial properties and relationships. Participants gave an average task load score of 39 from the NASA Task Load Index and gave a confidence level of 46/100 for actually using the prototype to physically navigate.

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