BACKGROUND Recovering from anterior cruciate ligament(ACL)reconstruction can be challenging.While standard rehabilitation helps restore knee function,many patients still face a slow or incomplete recovery.Extracorpore...BACKGROUND Recovering from anterior cruciate ligament(ACL)reconstruction can be challenging.While standard rehabilitation helps restore knee function,many patients still face a slow or incomplete recovery.Extracorporeal shockwave therapy(ESWT)has recently gained attention as a potential way to speed up healing and improve outcomes when added to traditional rehab.AIM To explore whether combining ESWT with standard postoperative rehabilitation truly leads to better recovery compared with rehab alone.METHODS A systematic review and meta-analysis were conducted using the Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines,evaluating participant status following ACL reconstruction with standard rehabilitation and without augmented ESWT.This meta-analysis included six studies(five randomized controlled trials,one non-randomized clinical study).The outcome measures were the Lysholm score,International Knee Documentation Committee score,visual analog score,and KT-1000 measurements.To compare the control and intervention groups,the weighted mean differences were calculated along with the 95%confidence intervals.The heterogeneity of the studies and publication bias were analyzed.RESULTS ESWT modestly improved Lysholm scores(weighted mean difference:3.72;95%confidence interval:-0.27 to 7.71)with high heterogeneity(I2:96%,P<0.001)when compared with standard rehabilitation.Focused ESWT showed greater benefits compared with radial ESWT.No significant differences were found in the International Knee Documentation Committee scores,visual analog score,or KT-1000 measurements.Substantial variability and publication bias were noted.CONCLUSION ESWT improved Lysholm scores but did not show other significant benefits.Due to the limited evidence,further standardized,placebo-controlled trials are needed to confirm its effectiveness in ACL reconstruction.展开更多
Perichondritis of the external ear is referred to inthe literature as pinna perichondritis as well as auricularperichondritis. Pinna （auricular） perichondritis is aninfection involving cartilage and subcutaneous tis...Perichondritis of the external ear is referred to inthe literature as pinna perichondritis as well as auricularperichondritis. Pinna （auricular） perichondritis is aninfection involving cartilage and subcutaneous tissue.The resulting infection produces swelling which canbe severe, and can lead to focal ear necrosis. The termperichondritis may even be considered a misnomer＂as the cartilage is almost always involved.＂[1] Pinna（auricular） perichondritis presents with signs andsymptoms that can include pain。展开更多
A 27-year-old male presented to the emergency department with acute exercise induced rhabdomyolysis （EIR） following low intensity, high repetition physical activity. It is paramount for the clinician to consider thi...A 27-year-old male presented to the emergency department with acute exercise induced rhabdomyolysis （EIR） following low intensity, high repetition physical activity. It is paramount for the clinician to consider this diagnosis in the differential of the patient presenting with a complaint of musculoskeletal pain. This case highlights the necessity of staying vigilant for a condition that can develop with seemingly minor, repetitive training of a single muscle group, such as in the exercise of calf raises.展开更多
INTRODUCTIONEctopic pregnancy occurs at a rate of 1%-2% of all pregnancies, and tends to occur at a higher rate （up to 4%） in patients receiving fertility treatments. Women with ectopic pregnancies are often asympto...INTRODUCTIONEctopic pregnancy occurs at a rate of 1%-2% of all pregnancies, and tends to occur at a higher rate （up to 4%） in patients receiving fertility treatments. Women with ectopic pregnancies are often asymptomatic or may complain of amenorrhea, vaginal spotting, and lower abdominal cramping pain.展开更多
INTRODUCTION The presentation of cardiogenic shock （CS） is usually straightforward, and includes hypotension, absence of hypovolemia, and clinical signs of poor tissue perfusion such as oliguria, cyanosis, cool ext...INTRODUCTION The presentation of cardiogenic shock （CS） is usually straightforward, and includes hypotension, absence of hypovolemia, and clinical signs of poor tissue perfusion such as oliguria, cyanosis, cool extremities and altered mentation. The most common etiology of CS is acute myocardial infarction, Here, we report a case of a 42-year-old male who presented with right flank pain, nausea and vomiting initially thought to be nephrolithiasis, which he had a history of but was ultimately diagnosed with CS due to a type II myocardial infarction. This case illustrates the importance of having a broad differential diagnosis especially when a patient＇s vital signs take a drastic turn since this patient initially resembled someone with nephrolithiasis.展开更多
文摘BACKGROUND Recovering from anterior cruciate ligament(ACL)reconstruction can be challenging.While standard rehabilitation helps restore knee function,many patients still face a slow or incomplete recovery.Extracorporeal shockwave therapy(ESWT)has recently gained attention as a potential way to speed up healing and improve outcomes when added to traditional rehab.AIM To explore whether combining ESWT with standard postoperative rehabilitation truly leads to better recovery compared with rehab alone.METHODS A systematic review and meta-analysis were conducted using the Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines,evaluating participant status following ACL reconstruction with standard rehabilitation and without augmented ESWT.This meta-analysis included six studies(five randomized controlled trials,one non-randomized clinical study).The outcome measures were the Lysholm score,International Knee Documentation Committee score,visual analog score,and KT-1000 measurements.To compare the control and intervention groups,the weighted mean differences were calculated along with the 95%confidence intervals.The heterogeneity of the studies and publication bias were analyzed.RESULTS ESWT modestly improved Lysholm scores(weighted mean difference:3.72;95%confidence interval:-0.27 to 7.71)with high heterogeneity(I2:96%,P<0.001)when compared with standard rehabilitation.Focused ESWT showed greater benefits compared with radial ESWT.No significant differences were found in the International Knee Documentation Committee scores,visual analog score,or KT-1000 measurements.Substantial variability and publication bias were noted.CONCLUSION ESWT improved Lysholm scores but did not show other significant benefits.Due to the limited evidence,further standardized,placebo-controlled trials are needed to confirm its effectiveness in ACL reconstruction.
文摘Perichondritis of the external ear is referred to inthe literature as pinna perichondritis as well as auricularperichondritis. Pinna （auricular） perichondritis is aninfection involving cartilage and subcutaneous tissue.The resulting infection produces swelling which canbe severe, and can lead to focal ear necrosis. The termperichondritis may even be considered a misnomer＂as the cartilage is almost always involved.＂[1] Pinna（auricular） perichondritis presents with signs andsymptoms that can include pain。
文摘A 27-year-old male presented to the emergency department with acute exercise induced rhabdomyolysis （EIR） following low intensity, high repetition physical activity. It is paramount for the clinician to consider this diagnosis in the differential of the patient presenting with a complaint of musculoskeletal pain. This case highlights the necessity of staying vigilant for a condition that can develop with seemingly minor, repetitive training of a single muscle group, such as in the exercise of calf raises.
文摘INTRODUCTIONEctopic pregnancy occurs at a rate of 1%-2% of all pregnancies, and tends to occur at a higher rate （up to 4%） in patients receiving fertility treatments. Women with ectopic pregnancies are often asymptomatic or may complain of amenorrhea, vaginal spotting, and lower abdominal cramping pain.
文摘INTRODUCTION The presentation of cardiogenic shock （CS） is usually straightforward, and includes hypotension, absence of hypovolemia, and clinical signs of poor tissue perfusion such as oliguria, cyanosis, cool extremities and altered mentation. The most common etiology of CS is acute myocardial infarction, Here, we report a case of a 42-year-old male who presented with right flank pain, nausea and vomiting initially thought to be nephrolithiasis, which he had a history of but was ultimately diagnosed with CS due to a type II myocardial infarction. This case illustrates the importance of having a broad differential diagnosis especially when a patient＇s vital signs take a drastic turn since this patient initially resembled someone with nephrolithiasis.
