The risk for venous thromboembolism (VTE) in total hip arthroplasty and hip fracture surgery is much higher than that of any other surgery. There is a general agreement that prevention of VTE in hip surgery patients is necessary due to concerns regarding symptomatic deep vein thrombosis or fatal pulmonary embolism. Optimal strategies for prevention of VTE include pharmacologic and mechanical approaches; however, the ideal prophylactic regimen has not been identified. Selection of a prophylactic regimen should be balanced between efficacy and safety. This article discusses the different prophylactic options available today for prevention of VTE in hip surgery patients.
Arthroplasty, Replacement, Hip ; Hip* ; Humans ; Pulmonary Embolism ; Venous Thromboembolism* ; Venous Thrombosis

Noncompaction of the ventricular myocardium is a rare congenital cardiomyopathy caused by arrest of normal endomyocardial embryogenesis. Isolated right ventricular noncompaction (IRNC) is an even rarer form of this disease. We report herein on a 68 year-old male diagnosed with IRNC who presented with right-sided heart failure, without involvement of the left ventricle. Diagnosis was achieved with the aid of echocardiography and ventriculography. Medical treatment including prescription of diuretics, a calcium channel blocker, and digitalis, improved both the symptoms and right ventricular function.
Calcium Channels ; Cardiomyopathies ; Diagnosis ; Digitalis ; Diuretics ; Echocardiography ; Embryonic Development ; Female ; Heart Failure ; Heart Ventricles ; Humans ; Male ; Myocardium ; Pregnancy ; Prescriptions ; Ventricular Function, Right

Coronary artery fistula draining into lung parenchymal vasculature has not been reported. Herein, we describe a case of an 81-year-old woman who presented with a localized pulmonary edema on right upper lobe associated with coronary fistula emptied into vasculature in right upper lobe. She underwent transcatheter closure of the fistula with an Amplatzer Vascular Plug 4, which resulted in complete occlusion and improved localized pulmonary edema.
Aged, 80 and over ; Coronary Vessels* ; Female ; Fistula* ; Humans ; Lung* ; Pulmonary Edema*

Background and Objectives: There is no clear standard for the difference in the thresholds of auditory brainstem response (ABR) and pure tone audiometry (PTA) when using ABR to evaluate the reliability of PTA. Therefore, we assessed the difference in the thresholds of ABR and PTA for each frequency. Consequently, we present here the actual difference values between the two tests that can be used as a reference in the clinic.Subjects and Method We retrospectively assessed the audiometry results of 129 ears. Ears in which the hearing thresholds of each frequency continuously declined were classified as the downward group. We compared the average of differences between the two tests by frequency. The differences were compared for each hearing level from 50 dB or higher. Results: For all ears, the appropriate range of difference value was ±5 dB at 2 kHz. At 1 kHz, the ABR threshold was 10 dB higher than PTA, and it was 10 dB less than PTA at 4 kHz. In the downward group, the difference value increased by 10 dB at 1 kHz and 4 kHz. In the subgroups at each hearing level, the difference value showed similar results (p<0.05). Conclusion The difference in the threshold, regardless of the severity or tendency of hearing loss, was the smallest at 2 kHz and the range was ±5 dB. ABR was 10 dB higher at 1 kHz and and 10 dB lower at 4 kHz than PTA. In the downward group, the difference at 1 kHz and 4 kHz increased by 10 dB each.

Background and Objectives: Patients with hearing loss and tinnitus experience difficulty in engaging in daily conversations. However, only few studies have examined how tinnitus affects individual speech discrimination to comprehend speech. This study aimed to analyze the correlation between tinnitus frequency and speech discrimination in patients with hearing loss and tinnitus.Subjects and Method A total of 275 ears with hearing impairment were retrospectively analyzed via audiometry and tinnitogram. The ears were divided into three groups depending on the frequency of their tinnitus. Average pure tone audiometry (PTA), hearing threshold of tinnitus frequency, speech discrimination test (SDT), degree of discrepancy between tinnitus frequency and worst PTA frequency were collected and compared among the three groups. Results: No significant difference was observed in PTA in the three patient groups. Hearing threshold of tinnitus frequency was the highest at 78.27 dB in the high-frequency group and the lowest at 45.14 dB in the low-frequency group. SDT was significantly lower (53.69%) in the low-frequency group. The correlation between tinnitus loudness and SDT was the strongest in the low-frequency group. The degree of discrepancy between tinnitus frequency and worst PTA frequency was also significantly observed in the low-frequency group. Conclusion Patients who are severely affected by tinnitus are found to have significant discrepancy between tinnitus frequency and worst PTA frequency, indicating decreased SDT.

BACKGROUND: Intraosseous lipoma is a very rare lesion that constitutes no more than 0.1% of all bone tumors. We analyzed 21 cases of intraosseous lipoma at a single institution for clinical and radiographic characteristics. METHODS: A retrospective study was performed on 21 pathologically confirmed intraosseous lipomas treated in our hospital from 2000 to 2017. Simple X-ray and magnetic resonance imaging findings and medical records were reviewed. Patients' age, sex, and clinical symptoms were investigated. From the radiographic images, the site of the lesion, calcification, bony expansion, and stage of the lesion were evaluated. Correlations between the degree of involution and clinical symptoms were analyzed. RESULTS: The mean age of patients was 50 years (range, 20 to 67 years), and there were 13 males and eight females. The mean lesion size was 6.1 cm (range, 2.5 to 13.6 cm). The most common anatomical site of the lesion was the femur (seven cases), and three cases occurred in flat bones such as the ilium and scapula. Visual analogue scale score for pain was 3 to 6 in 15 patients. There were no complaints of functional limitation. There was no correlation between the degree of degeneration and clinical symptoms (p = 1.000). Curettage was performed as a surgical treatment in 20 patients, and bone graft was performed using a bone chip. Excision was performed in one patient. Pain was resolved in seven of 11 patients with a complaint of preoperative pain; intermittent pain remained in four cases. There was no local recurrence or malignant change during the follow-up. CONCLUSIONS: There was no correlation between the degree of degeneration and clinical symptoms. Pain was the most common clinical symptom, but it was rarely accompanied by functional limitation. However, it is important to distinguish it from other pain-inducing disorders. The incidence of intraosseous lipomas is low, and detection based on various imaging findings can be difficult. Clear understanding of the radiographic findings and symptoms of intraosseous lipoma is helpful for diagnosis and differentiation.
Bone Neoplasms ; Curettage ; Diagnosis ; Female ; Femur ; Follow-Up Studies ; Humans ; Ilium ; Incidence ; Lipoma* ; Magnetic Resonance Imaging ; Male ; Medical Records ; Recurrence ; Retrospective Studies ; Scapula ; Transplants

Background: Deep vein thrombosis (DVT) is a common complication in orthopedic surgery and has the potential to lead to fatal complications such as pulmonary thromboembolism. However, the precise incidence and risk factors for DVT in the foot and ankle fields remain unclear. This study aimed to analyze the prevalence of DVT and identify its risk factors after foot and ankle surgery. Methods: Between September 2020 and July 2023, screening duplex ultrasonography was performed on 278 patients who underwent foot and ankle surgery and required immobilization. The findings from screening duplex ultrasonography were assessed in conjunction with the symptoms present at the time of diagnosis. Heterogeneous demographic data that could serve as potential risk factors for DVT, including diagnosis, body mass index, and other medical histories, were examined alongside pertinent surgeryrelated data, such as tourniquet time. Results: Among the 278 individuals, DVT occurred in 41 patients (14.7%). Among these, 92.7% originated at the calf level and the majority were asymptomatic. The cases originating above the calf accounted for 3 cases, representing 7.3% of patients diagnosed with DVT (1.1% of the entire screened population). Acute trauma, history of previous DVT, and old age were identified as statistically significant risk factors for DVT occurrence, with odds ratios of 2.44 (p = 0.04), 6.40 (p = 0.02), and 1.16 (p = 0.03), respectively. Conclusions After foot and ankle surgery, DVT occurred in 14.7% of cases. Acute trauma, history of DVT, and old age were identified as risk factors for DVT. These findings highlight the necessity of careful monitoring and appropriate prophylactic interventions for high-risk patients. Further investigation is required to determine effective prophylactic strategies for this patient population.

Background: Deep vein thrombosis (DVT) is a common complication in orthopedic surgery and has the potential to lead to fatal complications such as pulmonary thromboembolism. However, the precise incidence and risk factors for DVT in the foot and ankle fields remain unclear. This study aimed to analyze the prevalence of DVT and identify its risk factors after foot and ankle surgery. Methods: Between September 2020 and July 2023, screening duplex ultrasonography was performed on 278 patients who underwent foot and ankle surgery and required immobilization. The findings from screening duplex ultrasonography were assessed in conjunction with the symptoms present at the time of diagnosis. Heterogeneous demographic data that could serve as potential risk factors for DVT, including diagnosis, body mass index, and other medical histories, were examined alongside pertinent surgeryrelated data, such as tourniquet time. Results: Among the 278 individuals, DVT occurred in 41 patients (14.7%). Among these, 92.7% originated at the calf level and the majority were asymptomatic. The cases originating above the calf accounted for 3 cases, representing 7.3% of patients diagnosed with DVT (1.1% of the entire screened population). Acute trauma, history of previous DVT, and old age were identified as statistically significant risk factors for DVT occurrence, with odds ratios of 2.44 (p = 0.04), 6.40 (p = 0.02), and 1.16 (p = 0.03), respectively. Conclusions After foot and ankle surgery, DVT occurred in 14.7% of cases. Acute trauma, history of DVT, and old age were identified as risk factors for DVT. These findings highlight the necessity of careful monitoring and appropriate prophylactic interventions for high-risk patients. Further investigation is required to determine effective prophylactic strategies for this patient population.

Background: Deep vein thrombosis (DVT) is a common complication in orthopedic surgery and has the potential to lead to fatal complications such as pulmonary thromboembolism. However, the precise incidence and risk factors for DVT in the foot and ankle fields remain unclear. This study aimed to analyze the prevalence of DVT and identify its risk factors after foot and ankle surgery. Methods: Between September 2020 and July 2023, screening duplex ultrasonography was performed on 278 patients who underwent foot and ankle surgery and required immobilization. The findings from screening duplex ultrasonography were assessed in conjunction with the symptoms present at the time of diagnosis. Heterogeneous demographic data that could serve as potential risk factors for DVT, including diagnosis, body mass index, and other medical histories, were examined alongside pertinent surgeryrelated data, such as tourniquet time. Results: Among the 278 individuals, DVT occurred in 41 patients (14.7%). Among these, 92.7% originated at the calf level and the majority were asymptomatic. The cases originating above the calf accounted for 3 cases, representing 7.3% of patients diagnosed with DVT (1.1% of the entire screened population). Acute trauma, history of previous DVT, and old age were identified as statistically significant risk factors for DVT occurrence, with odds ratios of 2.44 (p = 0.04), 6.40 (p = 0.02), and 1.16 (p = 0.03), respectively. Conclusions After foot and ankle surgery, DVT occurred in 14.7% of cases. Acute trauma, history of DVT, and old age were identified as risk factors for DVT. These findings highlight the necessity of careful monitoring and appropriate prophylactic interventions for high-risk patients. Further investigation is required to determine effective prophylactic strategies for this patient population.

Background: Deep vein thrombosis (DVT) is a common complication in orthopedic surgery and has the potential to lead to fatal complications such as pulmonary thromboembolism. However, the precise incidence and risk factors for DVT in the foot and ankle fields remain unclear. This study aimed to analyze the prevalence of DVT and identify its risk factors after foot and ankle surgery. Methods: Between September 2020 and July 2023, screening duplex ultrasonography was performed on 278 patients who underwent foot and ankle surgery and required immobilization. The findings from screening duplex ultrasonography were assessed in conjunction with the symptoms present at the time of diagnosis. Heterogeneous demographic data that could serve as potential risk factors for DVT, including diagnosis, body mass index, and other medical histories, were examined alongside pertinent surgeryrelated data, such as tourniquet time. Results: Among the 278 individuals, DVT occurred in 41 patients (14.7%). Among these, 92.7% originated at the calf level and the majority were asymptomatic. The cases originating above the calf accounted for 3 cases, representing 7.3% of patients diagnosed with DVT (1.1% of the entire screened population). Acute trauma, history of previous DVT, and old age were identified as statistically significant risk factors for DVT occurrence, with odds ratios of 2.44 (p = 0.04), 6.40 (p = 0.02), and 1.16 (p = 0.03), respectively. Conclusions After foot and ankle surgery, DVT occurred in 14.7% of cases. Acute trauma, history of DVT, and old age were identified as risk factors for DVT. These findings highlight the necessity of careful monitoring and appropriate prophylactic interventions for high-risk patients. Further investigation is required to determine effective prophylactic strategies for this patient population.