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Background. The treatment of supraspinatus tendinopathy remains a challenge for the health professional. This study aims to analyze the precision of needle interventions in lesions of the supraspinatus tendon when conducting them in an ultrasound-guided or non-ultrasound guided (blind) manner. Methods. Study on cadaver with infiltrations performed under ultrasound control or blind after randomization of the parts and participants. Twenty fresh cadaveric shoulders and 30 practitioners with experience using musculoskeletal ultrasound and doing needle interventions. Each practitioner performed 4 ultrasound-guided and 4 unguided punctures. This provided 240 punctures that were analyzed in 3 different anatomical cuts, thus providing a database of 720 measurements for statistical analysis. Results. Statistically significant differences were observed (p<0.0001) in the distance to the bullet point between the ultrasound-guided and the non-guided infiltrations. It was estimated that the unguided punctures were performed on average 10mm farther from the bullet point than the 'ultrasound-guided' punctures. The ultrasound-guided punctures demonstrated 95% precision while the unguided punctures had a precision rate of 12.5% (p <0.0001). Conclusion. Interventions of the supraspinatus tendon should be performed in an ultrasound-guided manner to facilitate administration of the treatment in the proper area. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate risk factors associated with keratoconus in a monocentric cross-sectional case-control study., Methods: This observational study occurred from June 2019 to February 2021 in a university hospital (France). The case group consisted of 195 patients with keratoconus in at least one eye who were followed up by a corneal specialist. The control group consisted of 195 patients without any evidence of keratoconus on slit-lamp examination and corneal topography, who were matched 1 : 1 to controls by age and sex. Data were collected by a self-completed paper questionnaire before the consultation, and a multivariate logistic regression was performed., Results: Multivariate analysis revealed significant associations of keratoconus with family history (odds ratio [OR] = 22.2, p < 0.001), rubbing eyes (OR = 10.9, p < 0.001), allergy (any kind) (OR = 3.80, p < 0.001), smoking exposure (OR = 2.08, p =0.017), and dry eyes (OR = 1.77, p =0.045f). The worst eye was associated with the more rubbed eye ( p < 0.001) and the more pressed eye during the night according to sleeping position ( p < 0.041)., Conclusion: This study confirmed the association between keratoconus and eye rubbing, family history, and allergy. It highlighted the role of pressure on the eyes during sleep. Other less known risk factors such as dry eyes and smoking exposure should be explored in future studies., Competing Interests: The authors declare that there are no conflicts of interest., (Copyright © 2022 Eloi Debourdeau et al.)

Purpose: The present study aims to analyze the accuracy of injections aimed to hit the proximal and depth part of the patellar tendon "target point" in patellar tendinopathy, comparing ultrasound-guided or non-ultrasound-guided (blind) injections., Methods: A cadaver randomized study was carried out. Injections were performed under ultrasound control, as well as blinded. There were 26 knees from fresh cadavers and injections were placed by 26 practitioners with experience in the use of musculoskeletal ultrasound and injection treatment. Each participant performed 6 ultrasound-guided and 6 blind punctures in different cadaveric specimens. This provided 312 injections that were analyzed in 2 different anatomical cuts, thus providing a database of 624 measurements for statistical analysis., Results: Statistically significant differences were observed (p < 0.0001) in the distance from the target point between the ultrasound-guided and the non-guided infiltrations. The "unguided" injections were considered to have been performed on average 10 mm away from the target point compared to the "ultrasound-guided" injections. The ultrasound-guided injections obtained an accuracy of 74.36% while the "non-ultrasound-guided" injections obtained an accuracy of 11.54% (p < 0.0001)., Conclusion: The use of ultrasound to guide the positioning of injections on the dorsal side of the proximal patellar tendon had a significantly higher accuracy compared to blind injections. The finding provides knowledge of importance for injection treatment.

Introduction: The 90-day risk of cerebral infarction in patients with transient ischaemic attack (TIA) is estimated at between 8% and 20%. There is little consensus as to which diagnostic strategy is most effective. This study evaluates the benefits of early transthoracic echocardiography (TTE) with carotid and transcranial Doppler ultrasound in patients with TIA., Methods: Prospective study of patients with TIA in an emergency department setting. Demographic data, vascular risk factors, and ABCD(2) score were analysed. TIA aetiology was classified according to TOAST criteria. All patients underwent early vascular studies (<72hours), including TTE, carotid ultrasound, and transcranial Doppler. Primary endpoints were recurrence of stroke or TIA, myocardial infarction (MI), or vascular death during the first year., Results: We evaluated 92 patients enrolled over 24 months. Mean age was 68.3±13 years and 61% were male. The mean ABCD(2) score was 3 points (≥5 in 30%). The distribution of TIA subtypes was as follows: 12% large-artery atherosclerosis; 30% cardioembolism; 10% small-vessel occlusion; 40% undetermined cause; and 8% rare causes. Findings from the early TTE led to a change in treatment strategy in 6 patients (6.5%) who displayed normal physical examination and ECG findings. At one year of follow-up, 3 patients had experienced stroke (3.2%) and 1 patient experienced MI (1%); no vascular deaths were identified., Conclusions: In our TIA patients, early vascular study and detecting patients with silent cardiomyopathy may have contributed to the low rate of vascular disease recurrence., (Copyright © 2014 Sociedad Española de Neurología. Published by Elsevier España, S.L.U. All rights reserved.)