Risk Factors for Epistaxis in Thoroughbred Flat Races in Japan (2001–2020)

We investigated the risk factors for epistaxis in Japanese flat races over a 20-year period. The veterinary records of horses identified as having epistaxis by endoscopy on the race day, and the official racing records of all flat races from April to September between 2001 and 2020, were reviewed. The racecourses (n = 10), surface type, surface condition, race class, race distance, race year, sex, age, two training centers, ambient temperature, and body weight on race days were assessed using multivariable logistic regression (p p p < 0.001, especially Sapporo [OR; 4.74, 95% CI, 3.07–7.31], Hakodate [OR, 4.66; 95% CI, 3.05–7.11], and Kokura [OR, 4.14; 95% CI, 2.65–6.48] compared to the reference racecourse [Kyoto]). These results can facilitate developing interventions to reduce epistaxis in flat racing

Preoperative diagnosis of knee cartilage, meniscal, and ligament injuries by magnetic resonance imaging

Abstract Purpose The purpose of the study was to report on the current accuracy measures specific to 1.5‐Tesla MRI of the knee in the patient population prone to injuries of the anterior cruciate ligament (ACL), the menisci, and the articular cartilage. Methods We accrued patients between January 2018 through August 2021 who underwent a preoperative MRI and were diagnosed with an articular cartilage injury either due to unevenness of articular cartilage in T2‐weighted sequences or due to the irregularity of subchondral bone in T1‐weighted sequences. All patients were treated arthroscopically. Sensitivity, specificity, and accuracy were calculated for the detection of ACL, meniscus, and cartilage injuries. A P‐value of < 0.05 represented statistical significance. Results One‐hundred and forty‐seven cases which included 150 knee joints were enrolled in this study. The mean age at the time of surgery was 42.9 years‐old. The sensitivity in the diagnosis of ACL injuries was significantly greater than that in the diagnosis of cartilage injuries (P = 0.0083). The ratios of the equality of operative indication in 6 recipient sites were found to be between 90.0% and 96.0%. The diagnostic critical point was within a 1 cm in diameter. Conclusion The diagnostic sensitivity in cartilage injuries was significantly lower than ones of ACL and meniscal injuries. The ratios of the equality of operative indication was determined to be between 90.0% and 96.0%, if we consider the unevenness of articular cartilage or the irregularity of subchondral bone. Level of evidence Level III, Prospective diagnostic cohort study

Rectosigmoid colon venous malformation successfully treated with propranolol and celecoxib

The pathogenesis of venous malformation needs to be clarified and, although various treatment modalities are available, an optimal treatment has not been established. A 19-year-old girl presented with venous malformation of the rectosigmoid colon. She showed severe anemia due to rectal hemorrhage; her hemoglobin (Hb) level was 4.9 g/dl. A large venous malformation connected to an internal hemorrhoid was evident by endoscopy. Neither surgical resection nor sclerotherapy was indicated because of high blood flow in the venous malformation. Octreotide was initiated. However, the bleeding continued and she required persistent blood transfusions. We started propranolol in the 5th week of hospitalization. Celecoxib, which was started for her knee pain was found to be predictably effective, and we administered it regularly. Propranolol and celecoxib were gradually increased, the rectal bleeding decreased, and her anemia improved. Five months after the initiation of propranolol and celecoxib, she could maintain Hb at 15 g/dl without transfusion. Propranolol can contract blood vessels and celecoxib can inhibit vascular endothelial growth factor (VEGF) to result in anti-angiogenesis. This combination therapy might be useful for controlling intractable venous malformation