Bilateral multiligament injury of knee caused by entangled dupatta

We report a rare case of bilateral multiligament knee injury in an 18-year-old female employed in garment industry. Patient was wearing salwar kameez and dupatta while operating an electric laundry machine. In this case we discuss a peculiar mechanism of injury caused due to wearing dupatta near working site and suggest simple preventive measures.     

Individual variations in work output per unit energy intake in East Java

In studying East Javanese peasant farmers it was found that workers with low energy intakes were as productive as workers with high energy intakes. Measurements indicated that work output produced by a given energy intake varied considerably in relation to the individual consumer and that the work efficiency of the consumer varied inversely in relation to the degree of undernutrition or energy stress. It appeared that there may have been compensatory mechanisms such as higher levels of metabolic efficiency, lower basal metabolic rates, greater physical fitness, or stronger incentives to work enabling those on a low energy diet to produce more work per unit energy intake than individuals with relatively high energy intakes.     

Developing and sustaining a practice-based research infrastructure in a hospital social work department: Why is it important?

The future of hospital social work departments depends on their ability to demonstrate their effectiveness, efficiency, and consequently, their value to their host organizations. In order to demonstrate and enhance social work’s contribution, research activities of various kinds must be encouraged. These include research consumption as well as production and utilization by clinicians, supervisors, managers, and administrators. The authors sought to develop a sustainable research environment in a large social work department of an academic health system. Continued work is needed to understand practice-research “best practices” within hospitals and how to ensure their sustainability within an ever changing health care environment.     

Low‐density lipoprotein cholesterol lowering in real‐world patients treated with evolocumab

BackgroundLow‐density lipoprotein cholesterol (LDL‐C) is a risk factor for atherosclerotic cardiovascular disease (ASCVD). There are limited real‐world data on LDL‐C lowering with evolocumab in United States clinical practice.HypothesisWe assessed LDL‐C lowering during 1 year of evolocumab therapy.MethodsThis retrospective cohort study used linked laboratory (Prognos) and medical claims (IQVIA Dx/LRx and PharMetrics Plus^®) data. Patients with a first fill for evolocumab between 7/1/2015 and 10/31/2019 (index event) and LDL‐C ≥ 70 mg/dL were included (overall cohort; N = 5897). Additionally, a patient subgroup with a recent myocardial infarction (MI) within 12 months (median 130 days) before the first evolocumab fill was identified (N = 152). Reduction from baseline LDL‐C was calculated based on the lowest LDL‐C value recorded during a 12‐month follow‐up period.ResultsThe mean (SD) age was 65 (10) years; 61.9% of patients had ASCVD diagnoses and 70.7% of patients were in receipt of lipid‐lowering therapy. Following evolocumab treatment, changes in LDL‐C from baseline were −60% in the overall cohort (median [interquartile range (IQR)] 146 [115–180] mg/dL to 58 [36–84] mg/dL) and −65% in the recent MI subgroup (median [IQR] 137 [109–165] mg/dL to 48 [30–78] mg/dL). In the overall cohort and recent MI subgroup, 62.1% and 69.7% of patients achieved LDL‐C < 70 mg/dL, respectively.ConclusionsIn this real‐world analysis, evolocumab was associated with significant reductions in LDL‐C comparable to that seen in the FOURIER clinical trial, which were durable over 1 year of treatment.     

Steroid receptors in the adult zebra finch syrinx: a sex difference in androgen receptor mRNA, minimal expression of estrogen receptor alpha and aromatase

The zebra finch syrinx (sound production organ) is a sexually dimorphic component of the song system. Only male zebra finches sing, and in parallel, the overall mass and size of fibers in the two largest syrinx muscles are greater in males than females. Despite these obvious sexual dimorphisms, little is known about the role of steroid hormones in the maintenance of the structure and/or function of the syrinx. In this report, we used in situ hybridization to assess the expression of androgen receptor (AR), estrogen receptor alpha (ERalpha), and aromatase (AROM) mRNAs in the syrinx of adult male and female zebra finches. Increased AR mRNA expression was noted in males compared to females in two regions, over the ventralis muscle and in a band of connective tissue neighboring cartilage (perichondria). In contrast, we did not detect specific ERalpha or AROM mRNA expression within the syrinx. However, substantial ERalpha mRNA was present in oviduct, and aromatase mRNA was expressed at high levels in ovary. In parallel, an assay for AROM detected activity in ovary, but not in syrinx tissue from males or females. Taken together, these data suggest that the adult syrinx is sensitive to androgens; that sex differences in function and morphology of the syrinx may in part be due to increased expression of AR in males compared to females. In contrast, estrogen receptor alpha and AROM appear to have limited roles.     

Use of Mental Health Services by Adolescents After Traumatic Brain Injury: A Secondary Analysis of a Randomized Controlled Trial

Background

Mental health problems are common after pediatric traumatic brain injury (TBI). Many patients in need of mental health services do not receive them, but studies have not consistently used prospective and objective methods or followed samples for more than 1 year.

The Rodent Tibia Fracture Model: A Critical Review and Comparison With the Complex Regional Pain Syndrome Literature

Distal limb fracture is the most common cause of complex regional pain syndrome (CRPS), thus the rodent tibia fracture model (TFM) was developed to study CRPS pathogenesis. This comprehensive review summarizes the published TFM research and compares these experimental results with the CRPS literature. The TFM generated spontaneous and evoked pain behaviors, inflammatory symptoms (edema, warmth), and trophic changes (skin thickening, osteoporosis) resembling symptoms in early CRPS. Neuropeptides, inflammatory cytokines, and nerve growth factor (NGF) have been linked to pain behaviors, inflammation, and trophic changes in the TFM model and proliferating keratinocytes were identified as the primary source of cutaneous cytokines and NGF. Tibia fracture also activated spinal glia and upregulated spinal neuropeptide, cytokine, and NGF expression, and in the brain it changed dendritic architecture. B cell-expressed immunoglobulin M antibodies also contributed to pain behavior, indicating a role for adaptive immunity. These results modeled many findings in early CRPS, but significant differences were also noted.