Hernandezleth5539

Objectives Sensory loss may be a barrier to accessing healthcare services, and this study seeks to examine the association of sensory loss with whether older adults report having a usual source of health care. Methods Our study included 7548 older adults who participated in the National Health and Aging Trends Study in 2015. Having a self-reported usual source of health care was our outcome, and hearing and vision loss were our primary independent variables. Results In multivariate analysis accounting for demographics, socioeconomic, health status, and environmental covariates, near vision loss but not distance vision or hearing loss was associated with decreased odds of having a usual source of health care. Discussion That older adults with near vision loss were less likely to report having a usual source of health care is concerning. Examining barriers to care is needed to identify sensory loss-relevant processes to optimize and intervene upon.The role of circumcision in partially protecting against sexually transmitted infections (STIs) and other dermatoses has been documented. Neonatal circumcision is not routinely practiced in South America. Although it is logical to assume that male genital dermatoses are more prevalent in Hispanic men, they are underrepresented in the existing literature. Objective To describe the epidemiological characteristics from our male genital dermatology unit in Montevideo (Uruguay), the diagnoses, and correlate them with circumcision status and comorbidities. Methods A retrospective observational cohort study was conducted. A dermatologist and urologist evaluated all patients using standard questionnaires. In 3 years and 8 months, 269 patients were seen. Median age was 41, prevalence of neonatal circumcision was 0.7%, HIV was 4.2%, STIs were 24.9%, non-STIs were 63.9%, and both (STI + non-STI) were 11.2%. Most frequent entities eczema/balanoposthitis (27.1%), condyloma (24.9%), and lichen sclerosus (15.6%). Data correlating circumcision and other diagnoses did not reach statistical significance. HIV was positively associated with other STIs (p less then 0.05), and an association with balanoposthitis was seen; however, it did not reach statistical significance (p less then 0.1). Main limitation was small sample size. This is the first study of its kind based on Hispanic patients. Collaboration between specialties proved to be fundamental. Further studies are needed in this demographic to find an association between circumcision, comorbidities, and genital dermatoses.

When comprehensive arthroscopic management (CAM) for glenohumeral osteoarthritis fails, total shoulder arthroplasty (TSA) may be needed, and it remains unknown whether previous CAM adversely affects outcomes after subsequent TSA.

To compare the outcomes of patients with glenohumeral osteoarthritis who underwent TSA as a primary procedure with those who underwent TSA after CAM (CAM-TSA).

Cohort study; Level of evidence, 3.

Patients younger than 70 years who underwent primary TSA or CAM-TSA and were at least 2 years postoperative were included. A total of 21 patients who underwent CAM-TSA were matched to 42 patients who underwent primary TSA by age, sex, and grade of osteoarthritis. Intraoperative blood loss and surgical time were assessed. Patient-reported outcome (PRO) scores were collected preoperatively and at final follow-up including the American Shoulder and Elbow Surgeons (ASES) score, Single Assessment Numeric Evaluation (SANE), shortened version of Disabilities of the Arm, Shoulder and Hand (Qars]) and primary TSA (5.0 years [range, 2.0-11.5 years]) groups (

= .164). Both groups improved significantly from preoperatively to postoperatively in all PRO scores (

< .05). No significant differences in any median PRO scores between the CAM-TSA and primary TSA groups, respectively, were seen at final follow-up ASES 89.9 (interquartile range [IQR], 74.9-96.6) versus 94.1 (IQR, 74.9-98.3) (

= .545); SANE 84.0 (IQR, 74.0-94.0) versus 91.5 (IQR, 75.3-99.0) (

= .246); QuickDASH 9.0 (IQR, 3.4-27.3) versus 9.0 (IQR, 5.1-18.1) (

= .921); SF-12 PCS 53.8 (IQR, 50.1-57.1) versus 49.3 (IQR, 41.2-56.5) (

= .065); and patient satisfaction 9.5 (IQR, 7.3-10.0) versus 9.0 (IQR, 5.3-10.0) (

= .308).

Patients with severe glenohumeral osteoarthritis who failed previous CAM benefited similarly from TSA compared with patients who opted directly for TSA.

Patients with severe glenohumeral osteoarthritis who failed previous CAM benefited similarly from TSA compared with patients who opted directly for TSA.

Movement quality and neuromuscular balance are noted predictors of acute injury. Early sports specialization and extremely high activity levels have been linked to elevated risk of injury.

To investigate for any relationships among quality of physical movement, quantity of physical activity, and degree of sports specialization in a healthy cohort of active children and adolescents.

Cross-sectional study with prospectively collected data.

Healthy children between the ages of 10 and 18 years were recruited and completed the Hospital for Special Surgery Pediatric Functional Activity Brief Scale to assess quantity of physical activity and the Jayanthi scale to assess degree of sports specialization (high, score of 2 or 3; low, score of 0 or 1). Movement quality was assessed using motion analysis sensors during 5 repetitions of 4 different jumping and squatting motions, with a maximum score of 100 per participant. Independent-samples

tests were used to compare participants with high versus low specializovement quality score (



= 0.242;

= 3.0;

< .001).

This study found that sports specialization and physical activity levels were not associated with movement quality when controlling for age, which was the most important variable predicting athletic movement quality. Although all participants displayed movement patterns that were associated with high risk for injury, overall movement quality improved with advancing chronological age.

All young athletes should ensure that neuromuscular training accompanies sport-specific training to reduce risk of injury.

All young athletes should ensure that neuromuscular training accompanies sport-specific training to reduce risk of injury.

Medial patellofemoral ligament (MPFL) reconstruction is a common surgical treatment for patients with recurrent patellar instability. A variety of risk factors, such as age, trochlear dysplasia, patella alta, and increased tibial tubercle-trochlear groove (TT-TG) distance, have been identified and may lead to postoperative failure or poor outcomes.

While a large number of risk factors have been identified, significant heterogeneity exists in evaluating and reporting these risk factors in the literature. The goal of this study was to perform a systematic review to determine risk factors associated with worse outcomes after MPFL reconstruction and their consistency of being controlled for or analyzed among studies.

Systematic review; Level of evidence, 4.

A systematic review of the literature was performed using the MEDLINE database to identify relevant clinical outcome studies after MPFL reconstruction for recurrent patellar instability. Eligible studies were evaluated for risk factors that were associmographic, anatomic, and radiographic) reported to affect outcomes.After two strangers have briefly interacted with one another, both believe that they like their partner more than their partner likes them. A plausible explanation for this liking gap is that people are constantly worrying about how others are evaluating them. If so, one would expect the liking gap to emerge in young children as they become more concerned with their reputations and the impression they make on other people. The current study (N = 241 U.S. children; age range = 4-11 years) supported this hypothesis, showing a liking gap beginning when children were 5 years old, the age at which they first become concerned with other people's evaluations of them. Moreover, the liking gap became more pronounced as children got older. These findings provide the first developmental description of the liking gap and support the hypothesis that this phenomenon is related to individuals' concerns for how others evaluate them.

This study aimed to improve the impact of the metal artefact reduction (MAR) algorithm for the oral cavity by assessing the effect of acquisition and reconstruction parameters on an ultra-high-resolution CT (UHRCT) scanner.

The mandible tooth phantom with and without the lesion was scanned using super-high-resolution, high-resolution (HR), and normal-resolution (NR) modes. Images were reconstructed with deep learning-based reconstruction (DLR) and hybrid iterative reconstruction (HIR) using the MAR algorithm. BAY-61-3606 chemical structure Two dental radiologists independently graded the degree of metal artefact (1, very severe; 5, minimum) and lesion shape reproducibility (1, slight; 5, almost perfect). The signal-to-artefact ratio (SAR), accuracy of the CT number of the lesion, and image noise were calculated quantitatively. The Tukey-Kramer method with a

-value of less than 0.05 was used to determine statistical significance.

The HR

visual score was better than the NR

score in terms of degree of metal artefact (4.6 ± 0.5 and 2.6 ± 0.5,

< 0.0001) and lesion shape reproducibility (4.5 ± 0.5 and 2.9 ± 1.1,

= 0.0005). The SAR of HR

was significantly better than that of NR

(4.9 ± 0.4 and 2.1 ± 0.2,

< 0.0001), and the absolute percentage error of the CT number in HR

was lower than that in NR

(0.8% in HR

and 23.8% in NR

). The image noise of HR

was lower than that of NR

(15.7 ± 1.4 and 51.6 ± 15.3,

< 0.0001).

Our study demonstrated that the combination of HR mode and DLR in UHRCT scanner improved the impact of the MAR algorithm in the oral cavity.

Our study demonstrated that the combination of HR mode and DLR in UHRCT scanner improved the impact of the MAR algorithm in the oral cavity.

Two recent clinical trials have demonstrated that direct oral anticoagulants (DOACs) are effective as venous thromboembolism (VTE) prophylaxis in patients with moderate-to-high risk ambulatory cancer initiating chemotherapy. Patients with advanced ovarian cancer receiving neoadjuvant chemotherapy are at particularly increased risk of VTE. We performed a cost-effectiveness analysis from a health system perspective to determine if DOACs are a feasible prophylactic strategy in this population.

A simple decision tree was created from a health system perspective, comparing two strategies prophylactic DOAC taken for 18 weeks during chemotherapy versus no VTE prophylaxis. Rates of VTE (7.3% DOAC

13.6% no treatment), major bleeding (2.6%

1.3%), and clinically relevant nonmajor bleeding (4.6%

3.3%) were modeled. Cost estimates were obtained from wholesale drug costs, published studies, and Medicare reimbursement data. Probabilistic, one-way, and two-way sensitivity analyses were performed.

In the base ct investigation.Incontinence is a problem that can affect individuals of all ages. However, it is more frequently seen in older adults. It is a common geriatric syndrome, and its investigation should form part of a comprehensive geriatric assessment. Continence problems are usually ignored by patients and not reported to a medical professional, but with simple assessment and even simpler interventions, a significant improvement can be made for those living with incontinence. Most cases need a simple clinical assessment consisting of a good history and basic examination covering the abdomen, external genitalia and rectum. If no reversible causes are found, further investigations can be considered. The treatment for incontinence can be split into non-surgical and surgical management. Simple conservative measures, such as education around fluid intake, weight loss, managing constipation and pelvic floor exercises, can make a huge and positive impact on managing incontinence. If these are not effective, pharmaceutical therapies and surgical management can be considered, but there needs to be a careful consideration of the risk vs benefit in frail older adults.