Level III diagnostic study.
Spine osteomyelitis resulting from Bartonella infection is well described in the literature; however, little is known about nonspinal manifestations of Bartonella osteomyelitis. Here, we describe a case of femur osteomyelitis in a 5-year-old child and review the literature related to nonspinal manifestations of Bartonella. In the 33 cases reviewed, infection of the pelvic girdle was most commonly observed (42%), followed by femur (21%) and humerus infections (21%). Fever was the most common symptom, and interestingly, 18% of patients did not have any history of cat exposure. Osteomyelitis was most commonly identified by magnetic resonance imaging; however, Bartonella serology and tissue polymerase chain reaction testing were also positive when used. Recovery for most patients occurred after combination antibiotic therapy and did not require surgical debridement. In our patient, full recovery was achieved through surgical debridement and stabilization of the bone, followed by antibiotics.
Background: The primary objective of the Pediatric Orthopaedic Society of North America (POSNA)-Children’s Orthopaedics in Underserved Regions (COUR) Visiting Scholar Program is to engage emerging leaders from low-income and middle-income countries (LMICs) in POSNA educational offerings. This study aims to outline the educational and leadership activities pursued by the alumni of the POSNA-COUR Visiting Scholars Program. We hypothesized that there may be a discrepancy between visiting scholar interest level and actual participation in key follow-up educational and leadership activities. Methods: A 32-question online survey developed by the POSNA-COUR committee was electronically delivered to the POSNA-COUR visiting scholarship recipients from 2007 to 2019. The survey inquired about scholars’ educational background, clinical practice, and academic interests. Respondents also reported educational, research, and leadership activities that occurred following program participation. Results: Fifty-seven percent (44/77) of the previous scholars participated in the survey. Sixty-eight percent reported that >75% of their practice was comprised of pediatric patients. The COUR scholarship afforded 15 scholars the opportunity to attend their first educational conference in North America. The majority (86%) of respondents consulted POSNA members on care-related issues, 52% organized a POSNA member’s visit to their country, and 13% have become members of POSNA. Scholars shared their knowledge with colleagues through lectures (73%), demonstration of surgical skills (63%), mentorship (59%), hosting local courses (43%), and research (14%). There was a significant discrepancy between interest and actual participation in research (98% vs. 16%, P<0.0001), hosting a regional course (98% vs. 43%, P<0.0001), and becoming a member of POSNA (96% vs. 13%, P<0.0001). Conclusions: The POSNA-COUR Visiting Scholar Program is effective at providing beneficial educational opportunities to orthopaedic surgeons from LMICs. There is, however, a significant discrepancy between reported scholar interest and actual engagement in leadership endeavors including: research, organization of regional courses, and POSNA membership. The impact of the POSNA-COUR visiting scholar program can be enhanced through collaboration with scholarship alumni in these key areas. Level of Evidence: Level IV—case series.
Fibrosis continues to challenge the regeneration and repair of the Orthopaedic tissues in states of injury or disease. The mechanism behind developmental fibrosis has been widely investigated in the last few decades. However, the current efficacy of treatment for existing fibrous scars remains insufficient from both basic research and clinical perspectives. Scarred fibrotic tissue impedes the physical function of affected local tissues and organs and may also be associated with abnormal pain conduction or tissue reinjury. It is necessary to discover the functional treatment for fibrous scars as this pathology is medically demanding to effected patients. The current article will review the mechanisms behind fibrosis formation and the treatment potential in the field of the musculoskeletal system, especially in the pathology and treatment of injured skeletal muscle and the development of osteoarthritis.
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