67 research outputs found

    Ulnar-sided wrist pain. Part I: anatomy and physical examination

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    Ulnar-sided wrist pain is a common complaint, and it presents a diagnostic challenge for hand surgeons and radiologists. The complex anatomy of this region, combined with the small size of structures and subtle imaging findings, compound this problem. A thorough understanding of ulnar-sided wrist anatomy and a systematic clinical examination of this region are essential in arriving at an accurate diagnosis. In part I of this review, ulnar-sided wrist anatomy and clinical examination are discussed for a more comprehensive understanding of ulnar-sided wrist pain

    Application of multi‑method approach to assess groundwater–surface water interactions, for catchment management

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    Globally, the dependence of river systems to delayed discharge of subsurface water to augment flows during dry seasons is well documented. Discharge of fresh subsurface water can dilute concentrated river flow quality during reduced flow. Observed and reported results on the Berg River’s declining water quantity and quality are a concern to the regions socio-economic growth and environmental integrity. Understanding the role of subsurface water discharges on the quantity and quality of receiving surface water courses can improve their management during dry periods. A case study was designed and implemented in the upper Berg River catchment in the Western Cape Province of South Africa to assess the influence of groundwater–surface water interaction on water quantity and quality. This study aimed to quantify and characterize the quality of subsurface water available in the upper catchment to improve observed declining water quality downstream. Hydrograph separation provided estimates of water fluxes during 2012–2014 low and high flow periods, while hydrochemical analysis provided insights on impacts of major land use activity in this catchment on water resources. Hydrograph separation analysis indicated that the Berg River is 37.9% dependent on subsurface water discharges annually. Dominant Na–Cl-type water indicates the quality of water from the upper Berg River is largely affected by natural processes including short residence times of aquifer water, rock–water interactions and atmospheric deposition of NaCl ions. These results provide insights for suggesting management options to be implemented to protect subsurface water for continued dilution and water resources management in the lower catchments

    Ulnar-sided wrist pain. II. Clinical imaging and treatment

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    Pain at the ulnar aspect of the wrist is a diagnostic challenge for hand surgeons and radiologists due to the small and complex anatomical structures involved. In this article, imaging modalities including radiography, arthrography, ultrasound (US), computed tomography (CT), CT arthrography, magnetic resonance (MR) imaging, and MR arthrography are compared with regard to differential diagnosis. Clinical imaging findings are reviewed for a more comprehensive understanding of this disorder. Treatments for the common diseases that cause the ulnar-sided wrist pain including extensor carpi ulnaris (ECU) tendonitis, flexor carpi ulnaris (FCU) tendonitis, pisotriquetral arthritis, triangular fibrocartilage complex (TFCC) lesions, ulnar impaction, lunotriquetral (LT) instability, and distal radioulnar joint (DRUJ) instability are reviewed

    Sports-related wrist and hand injuries: a review

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    Microfluidic platform versus conventional real-time polymerase chain reaction for the detection of Mycoplasma pneumoniae in respiratory specimens.

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    Rapid, accurate diagnosis of community-acquired pneumonia (CAP) due to Mycoplasma pneumoniae is compromised by low sensitivity of culture and serology. Polymerase chain reaction (PCR) has emerged as a sensitive method to detect M. pneumoniae DNA in clinical specimens. However, conventional real-time PCR is not cost-effective for routine or outpatient implementation. Here, we evaluate a novel microfluidic real-time PCR platform (Advanced Liquid Logic, Research Triangle Park, NC) that is rapid, portable, and fully automated. We enrolled patients with CAP and extracted DNA from nasopharyngeal wash (NPW) specimens using a biotinylated capture probe and streptavidin-coupled magnetic beads. Each extract was tested for M. pneumoniae-specific DNA by real-time PCR on both conventional and microfluidic platforms using Taqman probe and primers. Three of 59 (5.0%) NPWs were positive, and agreement between the methods was 98%. The microfluidic platform was equally sensitive but 3 times faster and offers an inexpensive and convenient diagnostic test for microbial DNA

    Evaluation of a digital microfluidic real-time PCR platform to detect DNA of Candida albicans in blood.

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    Species of Candida frequently cause life-threatening infections in neonates, transplant and intensive care unit (ICU) patients, and others with compromised host defenses. The successful management of systemic candidiasis depends upon early, rapid diagnosis. Blood cultures are the standard diagnostic method, but identification requires days and less than half of the patients are positive. These limitations may be eliminated by using real-time polymerase chain reaction (PCR) to detect Candida DNA in the blood specimens of patients at risk. Here, we optimized a PCR protocol to detect 5-10 yeasts in low volumes of simulated and clinical specimens. We also used a mouse model of systemic candidiasis and determined that candidemia is optimally detectable during the first few days after infection. However, PCR tests are often costly, labor-intensive, and inconvenient for routine use. To address these obstacles, we evaluated the innovative microfluidic real-time PCR platform (Advanced Liquid Logic, Inc.), which has the potential for full automation and rapid turnaround. Eleven and nine of 16 specimens from individual patients with culture-proven candidemia tested positive for C. albicans DNA by conventional and microfluidic real-time PCR, respectively, for a combined sensitivity of 94%. The microfluidic platform offers a significant technical advance in the detection of microbial DNA in clinical specimens
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