Periprosthetic femur fractures (PPFX) are complications of both total hip and knee arthroplasty and may be treated with open reduction and internal fixation (ORIF) or revision arthroplasty. Differences in treatment and fracture location may be related to patient demographics and lead to differences in cost. selleck chemical Our study examined the effects of demographics and treatment of knee and hip PPFXs on length of stay (LOS) and cost. Of all, 932 patients were identified with hip or knee PPFXs in the National Inpatient Sample from January 2013 to September 2015. Age, gender, race, mortality, comorbidity level, LOS, total cost, procedure type, geographic region, and hospital type were recorded. A generalized linear regression model was conducted to analyze the effect of fracture type on LOS and cost. Differences in gender (66% vs 83.7% female, < .01), comorbidities (fewer in hips, < .01), and costs (US$30 979 vs US$27 944, < .01) were found between the hip and knee groups. Knees had significantly hi are not homogenous and treatment varies between hip and knee locations. For knee patients, those treated with ORIF were younger, with fewer comorbidities than those treated with revision. Conversely, hip patients treated with ORIF were older, with more comorbidities than those treated with revision. Hips had higher costs than knees, and cost correlated with revision arthroplasty and more comorbidities. In both hip and knee groups, longer LOS was associated with more comorbidities and being treated in urban teaching hospitals. Total cost had the strongest associations with revision procedures as well as number of comorbidities and blood product use. High-energy mechanisms of acetabular fracture in the geriatric population are becoming increasingly common as older adults remain active later in life. This study compared outcomes for high- versus low-energy acetabular fractures in older adults. We studied outcomes of 22 older adults with acetabular fracture who were treated at a level-I trauma center over a 4-year period. Fourteen patients were categorized as low-energy mechanism of injury, and 8 were identified as a high-energy mechanism. We analyzed patient demographics with univariate logistic regressions performed to assess differences in high- and low-energy group as well as patient characteristics compared with surgical outcomes. Most high-energy mechanisms were caused by motor vehicle collision (n = 4, 50.0%), with most having posterior wall fractures (50.0%). Among patient characteristics, the mechanism of injury, hip dislocation, fracture types, and fracture gap had the largest differences between energy groups effect size (ES 2.45, 1.43, 1.3ompared with patients with a low-energy fracture mechanism.Geriatric patients who sustained high-energy acetabular fractures tend to have higher overall rates of complications, including infection, traumatic arthritis, and heterotopic bone formation when compared with patients with a low-energy fracture mechanism.Metformin-associated lactic acidosis is a rare side effect in metformin poisoning. There is conflicting data about mortality rates changing from 3% to 83%. We aimed to discuss a case that developed lactic acidosis and acute renal failure progressing to mortality due to metformin intoxication. A 33 year-old female patient was admitted to the emergency department, with nausea and vomiting after taking 30 tablets of 1000 mg metformin. In the 2nd hour of follow-up, patient was observed to develop lactic acidosis which did not recover despite the infusion replacement treatments and hemodialysis. Following the development of respiratory failure, under mechanical ventilation, the patient developed cardiac arrest at the 48th hour of her admission. In metformin intoxications, it should be remembered that acidosis deepens very quickly and can progress with mortality despite optimal supportive therapy. More specific recommendations and further studies are required for the management and treatment of acute metformin-associated lactic acidosis.Kimura disease (KD) is a rare chronic benign inflammatory disorder of unknown etiology that is prevalent in Asian males. The head and neck region, especially the parotid glands and cervical lymph nodes, are most commonly affected. Diagnosis is based on clinicopathological features, while radiology findings are nonspecific. Although various treatment strategies have been proposed, there is a high recurrence rate. Combination therapy has been found to produce better results than monotherapy. We present a case of KD with huge parotid and cervical lymph node involvement that was treated with a combination of surgery and corticosteroids administered perioperatively.Carcinosarcoma is a rare type of malignant tumour that possess both the elements of carcinoma and sarcoma. They may occur in various locations such as the uterus, breast, thyroid, lung and gastrointestinal system. However, very few primary mediastinal carcinosarcomas have been reported. We are presenting a case of a 75-year-old male who presented with progressive dysphagia and hoarseness for 3 weeks. Contrast-enhanced computed tomography of the neck showed features of enlarged mediastinal necrotic nodes and the biopsy of this mass showed morphology and immunohistochemical profile that are consistent with carcinosarcoma. However, the patient succumbed to his illness soon after diagnosis.With the advancement of radiological investigation, intrapartum detection of fetal abnormalities is now precisely performed. Lymphangiomas are now diagnosed even before patient is born. The swelling may be gigantic and potentially life-threatening during the delivery. Nowadays, it is still a great challenge to doctors as how to deliver the baby together with the big neck mass. We present a case of huge intrapartum neck lymphangioma, for which we performed ex-utero intrapartum treatment (EXIT) procedure, followed by excision of the lesion later. The challenges on managing both mother and infant will be discussed.A shocking third species emerged from a family of coronaviruses (CoV) in late 2019 following viruses causing SARS (Severe Acute Respiratory Syndrome-CoV) in 2003 and MERS (Middle East Respiratory Syndrome-CoV) in 2012; it's a novel coronavirus now called severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2; formerly called 2019-nCoV). First emerging in China, it has spread rapidly across the globe, giving rise to significant social and economic costs and imposing severe strain on healthcare systems. Since many attempts to control viral spread has been futile, the only old practice of containment including city lockdown and social distancing are working to some extent. Unfortunately, specific antiviral drugs and vaccines remain unavailable yet. Many factors are encountered to play essential roles in viral pathogenesis. These include a broad viral-host range with high receptor binding affinity to various human tissues, viral adaptation to humans, a high percentage of asymptomatic but infected carriers, prolonged incubation, and viral shedding periods.