Femoroacetabular impingement in 45 professional athletes: associated pathologies and return to sport following arthroscopic decompression

Femoroacetabular impingement (FAI) occurs when an osseous abnormality of the proximal femur (cam) or acetabulum (pincer) triggers damage to the acetabular labrum and articular cartilage in the hip. Although the precise etiology of FAI is not well understood, both types of FAI are common in athletes presenting with hip pain, loss of range-of-motion, and disability in athletics. An open surgical approach to decompressing FAI has shown good clinical outcomes; however, this highly invasive approach inherently may delay or preclude a high level athlete’s return to play. The purpose of this study was to define associated pathologies and determine if an arthroscopic approach to treating FAI can allow professional athletes to return to high-level sport. Hip arthroscopy for the treatment of FAI allows professional athletes to return to professional sport. Between October 2000 and September 2005, 45 professional athletes underwent hip arthroscopy for the decompression of FAI. Operative and return-to-play data were obtained from patient records. Average time to follow-up was 1.6 years (range: 6 months to 5.5 years). Forty two (93%) athletes returned to professional competition following arthroscopic decompression of FAI. Three athletes did not return to play; however, all had diffuse osteoarthritis at the time of arthroscopy. Thirty-five athletes (78%) remain active in professional sport at an average follow-up of 1.6 years. Arthroscopic treatment of FAI allows professional athletes to return to professional sport.     

Bacteremias in liver transplant recipients: shift toward gram-negative bacteria as predominant pathogens.

During the 1990s, gram-positive bacteria emerged as major pathogens after liver transplantation. We sought to determine whether the pathogens associated with bacteremias in liver transplant recipients have changed. Patients included 233 liver transplant recipients transplanted between 1989 and 2003. The proportion of all infections due to bacteremias increased significantly over time (P <.0001). Of other major infections, a trend toward a decrease in fungal infections (P =.089) and a significant decrease in cytomegalovirus (CMV) disease (P =.0004) were documented. Whereas the proportion of bacteremias due to gram-negatives increased from 25% in the period of 1989-1993 to 51.8% in 1998-03, that of gram-positive bacteria decreased from 75% in the period of 1989-93 to 48.2% in the period of 1998-2003. Methicillin-resistant Staphylococcus aureus (MRSA), Klebsiella pneumoniae, and Pseudomonas aeruginosa were the most frequent pathogens in bacteremic patients. The incidence of bacteremias due to MRSA and Pseudomonas aeruginosa has remained unchanged (P <.20); however, that due to enteric gram-negative bacteria, particularly Klebsiella pneumoniae has increased (P =.02). Klebsiella pneumoniae isolates in the current quartile were not clonally related. In conclusion, bacteremias as a proportion of all infections in liver transplant recipients have increased significantly over time, due in part to a decline in infections due to other major pathogens, e.g., fungi, primarily Candida species, and CMV. Gram-negative bacteria have emerged as predominant pathogens in bacteremic liver transplant recipients.     

Endothelial dysfunction as a common link between erectile dysfunction and cardiovascular disease

Erectile dysfunction (ED) is often not considered in the same context as such traditional cardiovascular conditions as hypertension, dyslipidemia, diabetes, or ischemic heart disease. The detection of ED might be one of the most powerful tools to help manage cardiovascular disease in men. Clinical research suggests that the penile vascular bed is a sensitive indicator of early systemic endothelial cell or smooth muscle dysfunction. ED could be one of the initial signs of oxidative stress that occurs before the development of the structural, occlusive cardiovascular disease. ED is becoming a barometer of overall global cardiovascular risk and should be viewed in this context rather than as “just a problem with the penis.” Asking men about ED as part of the review of systems is an effective means of practicing preventive vascular medicine.     

Expression of CC Chemokine Ligand 20 and CC Chemokine Receptor 6 mRNA in Patients with Psoriasis Vuigaris

Itiswell knownthatimmune inflammatorymechanism playsanimportantroleinpsoriasis .Therelationshipbetweenchemokine ,receptorsandpsori asishasbeenconfirmed[1] .CCchemokineligand 2 0(CCL2 0 )isanewmemberinthefamilyof β chemokineandalsotheonlyligandofCCchemoki…     

Effect of Shenmai Injection on L-type Calcium Current of Diaphragmatic Muscle in Rats

Diaphragmaticmuscleisanimportantrespiratorymuscle,anddiaphragmaticfatiguecanleadtomanydisorders .Onlyintherecent 2 0 yearshavethesys temicresearchesbeen performedtoinvestigatethefunctionofdiaphragmanditspathophysiology .Di aphragmaticfatiguecanbeinducedby…