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The shoulder is a complex joint composed mostly of static and dynamic capsuloligamentous structures and plays an important role in forelimb lameness. Its complex anatomy and biomechanics necessitate thorough examination and diagnostic work-up for accurate diagnosis. This article provides an updated review of common canine shoulder pathologies, including osteochondrosis, bicipital and supraspinatus tendinopathies, infraspinatus contracture, medial shoulder syndrome, and luxation.Advanced imaging (ultrasound, computed tomography, MRI) is a key component in defining and localizing the underlying cause of forelimb lameness. Given the propensity of soft tissue injury/disease of the shoulder and brachial plexus, ultrasound and MRI are of particular utility in defining tendinous, muscular, and nerve lesions. An advanced knowledge of shoulder and brachial plexus anatomy is necessary for both image acquisition and interpretation. To determine clinical significance, interpretation of both normal anatomy and suspected pathology must be correlated with clinical signs and orthopedic examination findings.Humeral intracondylar fissure (HIF) was first described as incomplete ossification of the humeral condyle. It is now known that the fissure is a stress fracture in some dogs. The descriptive term HIF is therefore preferred. In young dogs an incomplete ossification cause may still be valid. Symptomatic HIF is treated surgically with a transcondylar implant. The aim is to alleviate lameness and avoid condylar fracture. Choosing an appropriate surgical approach and implant can reduce complications. HIF is not always symptomatic and, in these cases, surgical management is more controversial, because a minority of such cases become lame or fracture.

Although higher thyroidectomy volume has been linked with lower complication rates, its association with incidental parathyroidectomy remains less studied. The volume relationship is even less clear for central neck dissection, where individual parathyroid glands are at greater risk.

Patients undergoing thyroidectomy with or without central neck dissection were evaluated for incidental parathyroidectomy, hypoparathyroidism, and hypocalcemia. Univariate and multivariable analyses were performed using binary logistic regression.

Overall, 1,114 thyroidectomies and 396 concurrent central neck dissections were performed across 7 surgeons. Incidental parathyroidectomy occurred in 22.4% of surgeries (range, 16.9%-43.6%), affecting 7.1% of parathyroids at risk (range, 5.8%-14.5%). When stratified by surgeon, lower incidental parathyroidectomy rates were associated with higher thyroidectomy volumes (R

= 0.77, P= .008) and higher central neck dissection volumes (R

= 0.93, P < .001). On multivariable analysisal volume conferred a lower rate of incidental parathyroidectomy. Nonetheless, greater lymph node yield in central neck dissections did not result in greater parathyroid-related morbidity. Such findings support the value of leveraging surgical volume to both optimize oncologic resection and minimize complication rates.

Higher surgical volume conferred a lower rate of incidental parathyroidectomy. Nonetheless, greater lymph node yield in central neck dissections did not result in greater parathyroid-related morbidity. Such findings support the value of leveraging surgical volume to both optimize oncologic resection and minimize complication rates.

To know, in the population over 70, independent for walking, the prevalence of the concern to fall according to the short version of the Short Falls Efficacy Scale-International (FES-I) questionnaire, in old people living in the community and their associated factors.

Cross-sectional study.

Centro de Salud El Greco, Getafe, Madrid, Spain.

189 patients ≥70years with a Barthel ≥60, independent for walking (walk 45minutes without help or with a cane). The study was offered to a total of 328 people, of these accepted 217 and rejected 111.

The dependent variable, fear of falling (FOF), was evaluated by means of the short FES-I questionnaire, considering as a cut-off point for the positive screening of the MC a score ≥11. As independent variables we considered Barthel index, Downton scale, the Short Physical Performance Battery (SPPB) fragility test, falls in the last year, injuries associated with falls, time since the last fall, sensory deficit, use of gait devices, comorbidity and pharmacological treatment.

The prevalence of FOF was 42.9% (95%CI 35.5-50.2). The factors associated with FOF in the final multivariate analysis were female sex, living alone, high risk of falls, presence of frailty (SPPB≤9), use of hypotensive drugs, and injuries associated with previous falls.

The prevalence of FOF in older people is high. Pidnarulex in vitro Primary Care professionals should systematize the screening of this health problem, prioritizing especially in people who present the following risk factors being a woman, living alone, having a low score on the SPPB (as an indicator of frailty) or presenting a high risk of falls.

The prevalence of FOF in older people is high. Primary Care professionals should systematize the screening of this health problem, prioritizing especially in people who present the following risk factors being a woman, living alone, having a low score on the SPPB (as an indicator of frailty) or presenting a high risk of falls.

To evaluate the clinical relevance of indeterminate lung nodules (ILN) in patients with locally recurrent rectal cancer (LRRC) treated in a tertiary referral centre.

All patients with LRRC diagnosed between 2000 and 2017 were retrospectively reviewed. Reports of staging chest CT-scans were evaluated for ILN. Patients with distant metastases including lung metastases at time of LRRC diagnosis were excluded. Overall (OS), progression-free survival (PFS) and the cumulative incidence of lung metastases were compared between patients with and without ILN.

In total 556 patients with LRRC were treated during the study period. In the 243 patients eligible for analysis, 68 (28%) had ILN at LRRC diagnosis. Median OS was 37 months for both the patients with and without ILN (p=0.37). Median PFS was 14 months for the patients with ILN and 16 months for patients without ILN (p=0.80). After correction for potential confounding, ILN present at LRRC diagnosis was not associated with impaired OS or PFS (adjusted hazards ratio [95% confidence interval] 0.