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Aseptic loosening of femoral and acetabular components is a common complication following total hip arthroplasty (THA). It presents a significant diagnostic and therapeutic challenge for orthopedic surgeons, as it requires differentiation from infection and often necessitates complex revision surgery. We present the case of a 76-year-old female with a surgical history of total right hip arthroplasty performed one year prior. The patient presented with pain and limited mobility in the right lower extremity. Laboratory studies, including inflammatory markers and cultures, were negative for local or systemic infection. A biopsy of the right hip confirmed the absence of infection. Given these findings, a diagnosis of aseptic loosening was made. A revision right hip arthroplasty was undertaken, during which the acetabular component was found to be intact and was therefore retained. New femoral components were placed using an extended trochanteric osteotomy approach. Postoperatively, the patient demonstrated significant clinical improvement, regaining the ability to walk without support and exhibiting improved range of motion in the affected limb. Aseptic loosening of THA often requires revision surgery with component exchange to avoid any further complications that can increase morbidity and mortality. This produces a diagnostic and therapeutic challenge for the orthopedic surgeon due to the difficulty of cement retraction, previous implants, and the placement of new prosthetic components. Extended trochanteric osteotomy is an excellent tool for the orthopedic surgeon facing a revision of THA to remove the cement mantle and femoral stem and avoid complications., Competing Interests: Human subjects: Consent was obtained or waived by all participants in this study. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Gutiérrez-Jiménez et al.)

Immigration has become a focal debate in politics across the world. Recent research suggests that anti-immigration attitudes may have deep psychological roots in implicit disease avoidance motivations. A key implication of this theory is that individual differences in disease avoidance should be related to opposition to immigration across a wide variety of cultural and political contexts. However, existing evidence on the topic has come almost entirely from the United States and Canada. In this article, we test the disease avoidance hypothesis using nationally representative samples from Norway, Sweden, Turkey, and Mexico, as well as two diverse samples from the United States. We find consistent and robust evidence that disgust sensitivity is associated with anti-immigration attitudes and that the relationship is similar in magnitude to education. Overall, our findings support the disease avoidance hypothesis and provide new insights into the nature of anti-immigration attitudes.

Background: Fluoroscopic-guided lumbar procedures have increased in daily pain practice because the lumbar spine is one of the most common sources of pain. Interventional pain fellows must develop a minimum number of skills during their training in order to achieve the competences without neglecting radiological safety. However, medical training in fluoroscopic-guided interventions is being affected by the current coronavirus disease 2019 (COVID-19) situation., Methods: The objective of this study was to evaluate the use of a phantom model for lumbar injection as a training strategy during the COVID-19 pandemic in fellows of interventional pain. The study was divided into theoretical and practical modules. The hands-on practice was performed in a lumbar model phantom where fellows were evaluated in four fluoroscopically guided approaches: intra-articular facet block (IAFB), medial branch block (MBB), transforaminal block (TFB), and interlaminar block (ILB) divided in 5 sessions. The aim was to make as many punctures as possible in every session. We measured total procedural performance (TPP), total needle hand time (TNH), and total radiation dose generated by the fluoroscopic machine (TRD) during each procedure. Additionally, a survey was applied to evaluate confidence and satisfaction before and after training., Results: A total of 320 lumbar punctures were completed. The results were statistically significant in all approaches attempted (p < 0.01). The fellow's survey for satisfaction and confidence demonstrated a significant difference between pre and post-test (p < 0.01)., Conclusions: The results of this study highlight the importance of adaptations and adoption of new educational models. The use of the phantom model for simulation could be a strategy for other emerging situations, like the COVID-19 pandemic. Including this practice in the interventional pain programs could lead to better results for the patient and operator radiology safety., (© 2021 World Institute of Pain.)

Background: The Sertoli and Leydig cell tumor is an unusual neoplasm that belongs to the sex cord-stromal tumors. Generally these tumors are associated with good prognosis. These tumors usually present virilizing symptoms such as oligomenorrhea or amenorrhea, hirsutism, voice raucity, laryngeal protuberance and clitoromegaly., Case Presentation: A 12 year old girl referred acute abdominal pain with no other clinical manifestations. An abdominal ultrasound showed a semisolid mass suggestive of ovarian tumor. The diagnosis was confirmed by a computed tomography. A unilateral salpingo oophorectomy was performed and the pathologist reported a Sertoli-Leydig tumor with intermediate differentiation. The outcome was excellent., Conclusions: These tumors represent a rare condition in children. However, they can occur at any age, therefore it is important to acknowledge the clinical manifestations, diagnostic approach and therapeutic options. In this case the patient presented unusual symptoms which makes it more interesting.

The second survey deals with risk stratification in subjects, either adults or children, with ventricular preexcitation and no symptoms in their history. Current European electrophysiological practice is still variable among different centres. Although invasive stratification is still part of the practical management of asymptomatic subjects, a not negligible proportion of physicians do not completely rely on cut off values provided in the literature, proceeding to ablation irrespective of the stratification process. These concerns are mainly due to the perception of lack of strong evidence that, according to the majority of centres, is still needed.