Methods Three hundred patients receiving an anti-TNF-a treatment for chronic plaque psoriasis or psoriatic arthritis in a clinical setting in Italy, These patients were screened selleckchem through serum protein electrophoresis to investigate the possible development of MGUS. Results Eight patients were
found to have developed monoclonal gammopathy of undetermined significance. The median treatment duration for the eight patients was 1 year with excessive IgG present in five patients, IgM accumulation in one patient and a double monoclonal component in two patients. Conclusion Our data suggest that there may be an association between anti-TNF-a therapy and development of MGUS.”
“Various perioperative vascular complications of anterior lumbar spine procedures have been described in orthopaedic literature. We report the unusual case of a perioperative bleeding from the right and left epigastric inferior artery occurring when using a stand-alone ALIF device (Synfix, Synthes, Oberdorf, Switzerland) at the L5/S1 level through an anterior left retroperitoneal approach. The primary stability of the Synfix is achieved by four divergent screws which are inserted through the anteriorly located plate
into the neighbouring vertebral endplates. For the screw insertion the surrounding structures have to be mobilized more extensively than during a “standard” anterior lumbar interbody fusion (ALIF) procedure. The epigastric inferior arteries were MAPK inhibitor embolized by applying polyvinyl alcohol particles and metal coils. The retroperitoneal haematoma caused herniation of the external rectus sheath. Hence revision surgery with removal p38 MAP Kinase pathway of the haematoma and resuturing of the
rectus sheath were performed. Insertion of divergent screws of the Synfix device may cause severe distension and rupture of the epigastric vessels. This case shows that a lesion of the right epigastric artery may be a hazard even in left retroperitoneal approaches. To the author’s knowledge this is the first case describing a lesion of the right epigastric artery during an ALIF procedure through a left retroperitoneal approach.”
“Background Traumatic hand and finger amputations frequently lead to permanent disability.\n\nObjective To investigate their epidemiological characteristics and estimate the prevention potential among children 0-14 years old, through a cross-sectional survey.\n\nMethods Nationwide extrapolations were produced based on data recorded between 1996 and 2004 in the Greek Emergency Department Injury Surveillance System and existing sample weights. Incident and injury related characteristics were analysed to identify preventable causes.\n\nResults Among 197 417 paediatric injuries, 28 225(14%) involved the hand and fingers resulting in 236 amputations (similar to 1% of hand injuries). The annual probability to seek emergency department care for a hand injury was 3%. The estimated incidence rate (IR) of hand amputations was 19.7/100 000 person-years.