Management of chronic recurrent osteitis pubis/pubic bone stress in a Premier League footballer: Evaluating the evidence base and application of a nine-point management strategy

The tricuspid valve has been neglected for a long time and severe tricuspid regurgitation (TR) was largely undertreated in the past due to a high operative risk. In the last years we observed the development of different less invasive percutaneous options to treat TR. Currently, percutaneous treatments are reserved for high-risk patients presenting with advanced stage disease by which time they are likely to derive a partial benefit at best. There is a limited evidence base, including no randomized trials, to guide the management strategy for severe TR. In the interim we feel that choosing the best device for the most appropriate clinical candidate and with an adequate timing (most probably an “earlier” timing) will be the key combination to improve early and late outcomes of percutaneous treatments.

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Hip joint range of motion reduction in sports-related chronic groin injury diagnosed as pubic bone stress injury

Journal of Science and Medicine in Sport ◽

10.1016/s1440-2440(05)80027-1 ◽

2005 ◽

Vol 8 (1) ◽

pp. 77-84 ◽

Cited By ~ 85

Author(s):

GM Verrall ◽

IA Hamilton ◽

JP Slavotinek ◽

RD Oakeshott ◽

AJ Spriggins ◽

...

Keyword(s):

Range Of Motion ◽

Hip Joint ◽

Pubic Bone ◽

Stress Injury ◽

Bone Stress ◽

Joint Range Of Motion ◽

Joint Range ◽

Groin Injury

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Conservative treatment for intermittent claudication

Russian Medical Inquiry ◽

10.32364/2587-6821-2021-5-4-212-217 ◽

2021 ◽

Vol 5 (4) ◽

pp. 212-217

Author(s):

M.R. Kuznetsov ◽

◽

I.V. Reshetov ◽

S.V. Sapelkin ◽

N.V. Yasnopol’skaya ◽

...

Keyword(s):

Conservative Treatment ◽

Intermittent Claudication ◽

Lower Limb ◽

Management Strategy ◽

Evidence Base ◽

Walking Distance ◽

Atherosclerotic Plaques ◽

Antithrombotic Effect ◽

The Common ◽

Russian Medical

This paper discusses the issues emerging during the treatment of lower-limb arterial diseases and intermittent claudication. According to the international and Russian guidelines, the common management strategy for intermittent claudication is as follows: conservative treatment is recommended in patients without limiting intermittent claudication who can walk 30 m or more without pain. Drugs that are prescribed is these patients are addressed. No large well-designed studies on most of these drugs were conducted, therefore, it is challenging to assess their efficacy in patients with intermittent claudication. The authors focus on cilostazol that has the largest evidence base. This drug is included in the Russian and international clinical guidelines. Several students demonstrate that cilostazol provides antithrombotic effect, stabilizes atherosclerotic plaques, prevents hyperplasia of neointima and restenosis after vascular procedures, improves lipid metabolism, and significantly increases pain-free walking distance (intermittent claudication distance). Recent studies show that cilostazol can be used in the complex treatment for COVID-19 due to pleiotropic mechanism of action. KEYWORDS: lower-limb arterial diseases, intermittent claudication, conservative treatment, cilostazol, COVID-19, restenosis, antiplatelet therapy. FOR CITATION: Kuznetsov M.R., Reshetov I.V., Sapelkin S.V., Yasnopol’skaya N.V. Conservative treatment for intermittent claudication. Russian Medical Inquiry. 2021;5(4):212–217 (in Russ.). DOI: 10.32364/2587-6821-2021-5-4-212-217.

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Pneumothorax management: are the guidelines all-encompassing for the purpose of Acute Medicine?

Acute Medicine Journal ◽

10.52964/amja.0734 ◽

2018 ◽

Vol 17 (4) ◽

pp. 217-225

Author(s):

Rigers Cama ◽

◽

James Murray ◽

Nicholas Murch ◽

◽

...

Keyword(s):

Management Strategy ◽

Case Reports ◽

Evidence Base ◽

Pleural Space ◽

British Thoracic Society ◽

Acute Medicine ◽

Best Management ◽

Future Developments ◽

Considerable Morbidity ◽

Global Health Problem

Pneumothorax is defined as the presence of air in the pleural space, between the lung and the chest wall. It is a significant global health problem, with considerable morbidity and healthcare costs. Best management strategy remains controversial, with significant variation in practise, both nationally and internationally. The lack of consensus is driven by the paucity of the evidence base. Current research trials, particularly those looking at ambulatory management, are making progress and may help streamline future guidelines. This review presents five case reports of patients treated with methods which are not entirely synchronous with the current British Thoracic Society (BTS) guidelines; providing guidance for acute medical physicians who are routinely presented with such cases and exploring future developments in pneumothorax management.

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The prevalence and risk factors of pubic bone marrow edema in femoroacetabular impingement and hip dysplasia

Journal of Hip Preservation Surgery ◽

10.1093/jhps/hnab081 ◽

2021 ◽

Author(s):

Hiroki Shimodaira ◽

Akihisa Hatakeyama ◽

Hitoshi Suzuki ◽

Shinichiro Takada ◽

Yoichi Murata ◽

...

Keyword(s):

Bone Marrow Edema ◽

Hip Dysplasia ◽

Arthroscopic Surgery ◽

Alpha Angle ◽

Multivariate Logistic Regression Analysis ◽

Developmental Dysplasia ◽

Pubic Bone ◽

Multivariate Logistic Regression ◽

Osteitis Pubis ◽

Dysplasia Of The Hip

ABSTRACT Femoroacetabular impingement syndrome (FAIS) has been associated with osteitis pubis; however, it is still unclear whether hip dysplasia is associated with osteitis pubis. This study aimed to investigate (i) the incidence of pubic bone marrow edema (BME) on magnetic resonance imaging in symptomatic patients with FAIS, borderline developmental dysplasia of the hip (BDDH) and developmental dysplasia of the hip (DDH) undergoing hip arthroscopic surgery with labral preservation and (ii) the demographic and radiographic factors associated with pubic BME. A total of 259 symptomatic patients undergoing hip arthroscopic surgery between July 2016 and April 2019 were retrospectively reviewed and divided into three groups: FAIS (180 patients), BDDH (29 patients) and DDH (50 patients). Diffuse changes in the pubic bone adjacent to the pubic symphysis were labeled pubic BME, and the prevalence of their occurrence was examined. Multivariate logistic regression analysis was performed to identify factors involved in pubic BME, and odds ratios (ORs) for relevant factors were calculated. There was no significant difference in the prevalence of pubic BME among the three groups (20 [11.1%] of 180 FAIS patients, 6 [20.6%] of 29 BDDH patients and 7 [14%] of 50 DDH patients, P = 0.325). Multivariate logistic regression analysis showed that acetabular coverage was not associated with pubic BME, whereas younger age and greater alpha angle were still independent associated factors [age ≤26 years (OR, 65.7) and alpha angle ≥73.5° (OR, 4.79)]. Determining the possible association of osteitis pubis with cam impingement in dysplastic hips may provide insights toward a more accurate understanding of its pathophysiology.

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Acute Pyogenic Osteomyelitis of the Pubic Bone in a Patient with Systemic Lupus Erythematosus Mimicking Fracture of the Pubic Bone and Periprosthetic Joint Infection of the Hip

Case Reports in Orthopedics ◽

10.1155/2021/6665938 ◽

2021 ◽

Vol 2021 ◽

pp. 1-4

Author(s):

Aysha Rajeev ◽

Jason Mavrotas ◽

Sanjay Taribagil ◽

Jonathan Loughead

Keyword(s):

Systemic Lupus Erythematosus ◽

Lupus Erythematosus ◽

Joint Infection ◽

Pelvic Bone ◽

Pubic Bone ◽

Delayed Presentation ◽

Systemic Lupus ◽

Osteitis Pubis ◽

Clinical Awareness ◽

Pyogenic Osteomyelitis

Introduction. Pubic bone osteomyelitis is atypical, and the diagnosis is often overlooked. It may present as osteitis pubis, fracture, or noninfectious inflammation of the pubic symphysis. Case Report. We report a case of a 65-year-old lady who has systemic lupus erythematosus with acute pyogenic osteomyelitis of the pubic bone who presented initially with a suspicious healing pubic rami fracture and periprosthetic infection of the hip joint. Conclusion. Acute osteomyelitis of the pubic bone has often an infrequent and delayed presentation. Clinical awareness, early diagnosis, and appropriate treatment including surgical debridement and long-term antibiotics can prevent ongoing morbidities such as chronic osteomyelitis, pain, and deformities of pelvic bone and joints.

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Classifying Disfluencies in Preschool- and School-Age Spanish–English Bilinguals Who Do Not Stutter: An Exploratory Study

Perspectives of the ASHA Special Interest Groups ◽

10.1044/2019_persp-19-00164 ◽

2020 ◽

Vol 5 (1) ◽

pp. 119-130

Author(s):

Raúl Rojas ◽

Farzan Irani

Keyword(s):

Exploratory Study ◽

Evidence Base ◽

Medium Effect ◽

Bilingual Children ◽

Linear Regression Models ◽

Cross Sectional ◽

Total Percentage ◽

Narrative Production ◽

Language Measures ◽

Mean Length Of Utterance

Purpose This exploratory study examined the language skills and the type and frequency of disfluencies in the spoken narrative production of Spanish–English bilingual children who do not stutter. Method A cross-sectional sample of 29 bilingual students (16 boys and 13 girls) enrolled in grades prekindergarten through Grade 4 produced a total of 58 narrative retell language samples in English and Spanish. Key outcome measures in each language included the percentage of normal (%ND) and stuttering-like (%SLD) disfluencies, percentage of words in mazes (%MzWds), number of total words, number of different words, and mean length of utterance in words. Results Cross-linguistic, pairwise comparisons revealed significant differences with medium effect sizes for %ND and %MzWds (both lower for English) as well as for number of different words (lower for Spanish). On average, the total percentage of mazed words was higher than 10% in both languages, a pattern driven primarily by %ND; %SLDs were below 1% in both languages. Multiple linear regression models for %ND and %SLD in each language indicated that %MzWds was the primary predictor across languages beyond other language measures and demographic variables. Conclusions The findings extend the evidence base with regard to the frequency and type of disfluencies that can be expected in bilingual children who do not stutter in grades prekindergarten to Grade 4. The data indicate that %MzWds and %ND can similarly index the normal disfluencies of bilingual children during narrative production. The potential clinical implications of the findings from this study are discussed.

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Bang for Your Buck: A Single-Case Experimental Design Study of Practice Amount and Distribution in Treatment for Childhood Apraxia of Speech

Journal of Speech Language and Hearing Research ◽

10.1044/2019_jslhr-s-18-0212 ◽

2019 ◽

Vol 62 (9) ◽

pp. 3160-3182 ◽

Cited By ~ 4

Author(s):

Edwin Maas ◽

Christina Gildersleeve-Neumann ◽

Kathy Jakielski ◽

Nicolette Kovacs ◽

Ruth Stoeckel ◽

...

Keyword(s):

Single Case ◽

Evidence Base ◽

Distributed Practice ◽

Single Subject ◽

Single Subject Design ◽

Apraxia Of Speech ◽

Childhood Apraxia Of Speech ◽

Opposite Pattern ◽

Massed Practice ◽

Treatment Conditions

Purpose The aim of this study was to examine 2 aspects of treatment intensity in treatment for childhood apraxia of speech (CAS): practice amount and practice distribution. Method Using an alternating-treatments single-subject design with multiple baselines, we compared high versus low amount of practice, and massed versus distributed practice, in 6 children with CAS. Conditions were manipulated in the context of integral stimulation treatment. Changes in perceptual accuracy, scored by blinded analysts, were quantified with effect sizes. Results Four children showed an advantage for high amount of practice, 1 showed an opposite effect, and 1 showed no condition difference. For distribution, 4 children showed a clear advantage for massed over distributed practice post treatment; 1 showed an opposite pattern, and 1 showed no clear difference. Follow-up revealed a similar pattern. All children demonstrated treatment effects (larger gains for treated than untreated items). Conclusions High practice amount and massed practice were associated with more robust speech motor learning in most children with CAS, compared to low amount and distributed practice, respectively. Variation in effects across children warrants further research to determine factors that predict optimal treatment conditions. Finally, this study adds to the evidence base supporting the efficacy of integral stimulation treatment for CAS. Supplemental Material https://doi.org/10.23641/asha.9630599

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