1.Results of Posterior Dislocation of Elbow Associated with Bony and Soft Tissue Injury
Neel M Bhavsar ; Jyotish G Patel ; Pankaj R Patel ; Jigar B Chhapan
Malaysian Orthopaedic Journal 2013;7(1):13-18
Elbow trauma is challenging to manage by virtue of its
complex articular structure and capsuloligamentous and
musculotendinous arrangements. We included 17 patients
with elbow dislocation and associated injuries in this study.
The study protocol included early elbow reduction and
planned fixation of the medial or lateral condyle, coronoid
and radial head. The sample was 73% male and 27% female
with mean duration follow-up of 8 months, and mean age of
37 years. The mean Mayo Elbow Performance Score was 96
points at conclusion of follow-up, indicating an excellent
result in 14 patients. Whenever the radial head was excised, we performed a strong transosseous ligamentous repair of the medial and lateral collateral ligaments. Fixation of the coronoid is essential for elbow stability. A small avulsed fragment can be fixed using an ACL jig. We found this technique very useful. Early planned intervention, stable fixation, and repair provide sufficient stability and enhance functional outcomes.
2.Superior sagittal sinus dural arteriovenous fistula caused by treatment of meningioma masquerades as sinus thrombosis
Michael J. GIGLIOTTI ; Neel PATEL ; Scott SIMON
Journal of Cerebrovascular and Endovascular Neurosurgery 2021;23(3):260-265
Dural arteriovenous fistulas (DAVF) are rare acquired lesions resulting from abnormal shunting between intracranial dural arteries and venous system. Typically arising from structural weakness of the dura and a coinciding trigger factor, DAVFs can present with similar clinical and imaging characteristics to sinus thrombosis. A 61-year-old male with a history of meningioma previously managed with subtotal resection and stereotactic radiosurgery presented with progressive right-sided vision loss and bilateral papilledema. Initial imaging suggested possible sinus occlusion. Catheter angiogram revealed a Borden-Shucart grade III DAVF of the superior sagittal sinus and elevated venous pressures and the patient subsequently underwent endovascular transarterial intervention twice. We report on the first case of a superior sagittal sinus DAVF occurring after surgical resection of a parasagittal meningioma.
3.Superior sagittal sinus dural arteriovenous fistula caused by treatment of meningioma masquerades as sinus thrombosis
Michael J. GIGLIOTTI ; Neel PATEL ; Scott SIMON
Journal of Cerebrovascular and Endovascular Neurosurgery 2021;23(3):260-265
Dural arteriovenous fistulas (DAVF) are rare acquired lesions resulting from abnormal shunting between intracranial dural arteries and venous system. Typically arising from structural weakness of the dura and a coinciding trigger factor, DAVFs can present with similar clinical and imaging characteristics to sinus thrombosis. A 61-year-old male with a history of meningioma previously managed with subtotal resection and stereotactic radiosurgery presented with progressive right-sided vision loss and bilateral papilledema. Initial imaging suggested possible sinus occlusion. Catheter angiogram revealed a Borden-Shucart grade III DAVF of the superior sagittal sinus and elevated venous pressures and the patient subsequently underwent endovascular transarterial intervention twice. We report on the first case of a superior sagittal sinus DAVF occurring after surgical resection of a parasagittal meningioma.
4.Trends and Outcomes of Type 2Myocardial Infarction During the COVID-19 Pandemic in the United States
Harshith THYAGATURU ; Nicholas ROMA ; Aakash ANGIREKULA ; Sittinun THANGJUI ; Alex BOLTON ; Karthik GONUGUNTLA ; Yasar SATTAR ; Muchi Ditah CHOBUFO ; Abhiram CHALLA ; Neel PATEL ; Gayatri BONDI ; Sameer RAINA
Korean Circulation Journal 2023;53(12):829-839
Background and Objectives:
There is limited data on the impact of type 2 myocardial infarction (T2MI) during the coronavirus disease 2019 (COVID-19) pandemic.
Methods:
The National Inpatient Sample (NIS) database from January 2019 to December 2020 was queried to identify T2MI hospitalizations based on the appropriate International Classification of Disease, Tenth Revision-Clinical Modification codes. Monthly trends of COVID-19 and T2MI hospitalizations were evaluated using Joinpoint regression analysis. In addition, the multivariate logistic and linear regression analysis was used to compare inhospital mortality, coronary angiography use, and resource utilization between 2019 and 2020.
Results:
A total of 743,535 patients hospitalized with a diagnosis of T2MI were identified in the years 2019 (n=331,180) and 2020 (n=412,355). There was an increasing trend in T2MI hospitalizations throughout the study period corresponding to the increase in COVID-19 hospitalizations in 2020. The adjusted odds of in-hospital mortality associated with T2MI hospitalizations were significantly higher in 2020 compared with 2019 (11.1% vs. 8.1%:adjusted odds ratio, 1.19 [1.13–1.26]; p<0.01). In addition, T2MI hospitalizations were associated with lower odds of coronary angiography and higher total hospitalization charges,with no difference in the length of stay in 2020 compared with 2019.
Conclusions
We found a significant increase in T2MI hospitalizations with higher inhospital mortality, total hospitalization costs, and lower coronary angiography use during the early COVID-19 pandemic corresponding to the trends in the rise of COVID-19 hospitalizations. Further research into the factors associated with increased mortality can increase our preparedness for future pandemics.