Adductor Canal Block or Local Infiltrate Analgesia for Pain Control After Total Knee Arthroplasty? A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Background

Total knee arthroplasty is a treatment option for debilitating arthritis. In the postoperative period, patients experience moderate to severe pain affecting the rehabilitation, hospital stay, and patient satisfaction. This study aims at utilizing current best evidence to determine whether adductor canal block (ACB) or periarticular injection (PAI) is a better modality for managing short-term postoperative pain and opioid consumption.

Limitations of the keyhole technique for quantitative dynamic contrast-enhanced breast MRI

The effect of keyhole data acquisition on quantitative analysis of dynamic MRI was examined. Experiments were performed retrospectively on raw data obtained from clinical dynamic contrast-enhanced breast imaging procedures. The effects of keyhole phase-encoding acquisition and type of reconstruction algorithm on the accuracy of derived quantitative parameters was assessed. Results indicate that the minimum keyhole size used should be restricted by the approximate minimum size of the expected lesions. Furthermore, reconstruction algorithms that offer improved image resolution do not circumvent this restriction.     

Expression of a suppressive p15E-related epitope in colorectal and gastric cancer.

mRNA for the suppressive epitope of p15E was found to be present in 24 of 30 samples of human colorectal cancer and in all four specimens of gastric cancer. mRNA for p15E was seldom seen in nonmalignant colonic or gastric mucosa but, when present, was associated with inflammatory or pre-malignant conditions of the digestive tract. Synthetic peptides derived from the conserved p15E sequence were found to suppress some aspects of the immune response implicated in anti-tumour activity. These data suggest that a p15E-related material with immunomodulatory properties is elaborated within human tumours, either by the tumour itself or as a normal component of the endogenous anti-tumour reaction.     

Noninvasive Estimation of Blood Alcohol Concentrations: Ethanol Vapor Above the Eye

The present study describes, in animals, a novel approach to the in vivo, noninvasive determination of alcohol in the body. The concentration of ethanol in vapor above the lacrimal fluid in the eye was analyzed in situ by the use of a fast (1-min) gas sensor method developed previously for biological liquids. After an oral dose of 1 g/kg to 11 animals, eye vapor measurements and blood samples were obtained over 4 hr. The correlation of 61 blood ethanol concentrations obtained by the two methods yielded a correlation coefficient of 0.92 and a slope of 0.99. The metabolic rates of ethanol determined by gas chromatographic analysis of blood and by ethanol eye vapor analysis are virtually identical. The data suggest that ethanol eye vapor analysis may be an attractive, noninvasive method for the determination of ethanol in animals. The method is not subject to false high readings due to alcohol in the buccal cavity and thus might constitute an alternative to breath analysis in the human. In a separate series, ethanol was determined by head space gas chromatography in samples of blood and lacrimal fluid while the animals were under ketamine anesthesia. The correlation of ethanol concentrations in blood and lacrimal fluid (r = 0.99) shows that ethanol is distributed in lacrimal fluid which comprises part of total body water.     

Tamponade due to hemopericardium after streptokinase therapy for pulmonary embolism

A 67-year-old man was given intravenous heparin and then streptokinase for an acute severe pulmonary embolism. The next day a large pericardial effusion developed, with tamponade. Aspiration of blood (500 ml) from the pericardial sac produced prompt relief. The possibility of hemopericardium causing tamponade should be considered on unexplained worsening of cardiac status in a patient who has recently received streptokinase for pulmonary embolism or myocardial infarction.