Fitzgeraldallred0040
d in sub-Saharan Africa.
Polyethylene (PE) wear remains a common reason for revision surgery following total hip arthroplasty (THA). An established treatment method is isolated liner exchange in a well-fixed acetabular cup and entails a known high risk of hip dislocation after revision surgery. The purpose of this retrospective study was to determine the rate of hip dislocation after liner exchange.
Patients were included if (1) the PE liner was removable, (2) the acetabular shell was stable with acceptable orientation, (3) no osteolysis around the acetabular cup was found and (4) no dislocation of the THA occurred before revision surgery. We reviewed medical histories and performed radiological measurements using Einzel-Bild-Röntgen-Analyse (EBRA) software. EBRA measurements and statistical investigations were performed by two independent investigators.
A total of 82 patients were included in our study. Mean follow-up was six (range 3.6-9.9) years. In 13 (15.8%) patients THA dislocations occurred at a mean postoperative period of 20.2 (range 1-44) weeks after revising the PE liner. This is equivalent to an absolute risk increase of 16% after revision surgery, which results in a number needed to harm of 6. This means that every sixth patient with isolated liner exchange can expect to experience dislocation due to wear.
In conclusion, isolated exchange of the polyethylene liner because of wear showed a high risk of dislocation and further cup revision. Our results suggest that the threshold for revising well-fixed components in the case of liner wear should be lowered.
Number 20140710-1012 and Date 2016-03-09.
Number 20140710-1012 and Date 2016-03-09.
Although a large number of previous studies have investigated the outcome in patients following tibial shaft fractures, the literature provides limited information on prospectively reported patients with mid- to long-term follow-up. The present study aimed to investigate prospectively the 5-year development in patient-reported quality of life after intramedullary nailing of a tibial shaft fracture.
The design was a prospective, 5-year follow-up cohort study. Quality of life (QOL) was measured with the questionnaire Eq5d-5L and compared to the 1-year outcome reported by the same patients. Secondary outcome measurements were the Knee Injury and Osteoarthritis Outcome Score (KOOS), recordings of pain, gait and muscle strength.
Twenty-nine patients were eligible for participation. Mean patient age at the time of the 5-year follow-up was 46.3years. The 5-year postoperative mean Eq5d-5L index was 0.864 (95% CI 0.809-0.918). The mean Eq5d-5L VAS was 88.4 (95% CI 83.4-93.5). Compared with the same patients' Eq5f a reference population at the 5-year follow-up. In a clinical setting, these results highlight that patients may expect a prolonged period to recover. However, of most importance is that patients can expect a satisfactory outcome years after fracture and treatment.
Coronavirus disease 2019 (COVID-19) is a global pandemic. Critically ill patients often require prolonged intubation for mechanical ventilation to support breathing; thus, the artificial airway must be managed by tracheotomy. Therefore, studies exploring appropriate and safe methods for tracheotomy that minimize the risks of nosocomial transmission are important.
A retrospective analysis of the clinical characteristics of 14 critically ill patients with COVID-19, who underwent bedside tracheotomy from March to April 2020 was conducted to summarize the indications for tracheotomy and key points related to personal protective equipment and surgical procedures.
All 14 patients were diagnosed with COVID-19 and were critically ill. All tracheotomies were performed in the late phase of the infection course. The interval between the infection and tracheotomy was 33 days, and the median interval between intubation and tracheotomy was 25.5 days. The reverse transcription-polymerase chain reaction results of secrrelatively low risk of infection. Adherence to key steps in the tracheotomy procedure and donning adequate personal protection will help medical staff avoid infection.
Child pedestrian injuries represent a global public health burden. To date, most research on psychosocial factors affecting children's risk of pedestrian injury focused on cognitive aspects of children's functioning in traffic. Recent evidence suggests, however, that emotional aspects such as temperament-based fear and anger/frustration, as well as executive function-based emotional decision making, may also affect children's safety in traffic. This study examined the role of emotions on children's pedestrian behavior. Three hypotheses were considered (a) emotion-based temperament factors of fear and anger/frustration will predict children's risky decisions and behaviors; (b) emotional decision making will predict risky pedestrian decisions and behaviors; and (c) children's pedestrian decision making will mediate relations between emotion and risky pedestrian behavior. The role of gender was also considered.
In total, 140 6- to 7-year-old children (M = 6.7 years, SD = 0.39; 51% girls) participated. Parenton regulation training into child pedestrian education programs.
This guideline will provide the practicing endocrinologist with an approach to the assessment and treatment of dyslipidemia in patients with endocrine diseases, with the objective of preventing cardiovascular (CV) events and triglyceride-induced pancreatitis. The guideline reviews data on dyslipidemia and atherosclerotic cardiovascular disease (ASCVD) risk in patients with endocrine disorders and discusses the evidence for the correction of dyslipidemia by treatment of the endocrine disease. The guideline also addresses whether treatment of the endocrine disease reduces ASCVD risk.
This guideline focuses on lipid and lipoprotein abnormalities associated with endocrine diseases, including diabetes mellitus, and whether treatment of the endocrine disorder improves not only the lipid abnormalities, but also CV outcomes. Based on the available evidence, recommendations are made for the assessment and management of dyslipidemia in patients with endocrine diseases.
This guideline focuses on lipid and lipoprotein abnormalities associated with endocrine diseases, including diabetes mellitus, and whether treatment of the endocrine disorder improves not only the lipid abnormalities, but also CV outcomes. Based on the available evidence, recommendations are made for the assessment and management of dyslipidemia in patients with endocrine diseases.
To explore the features of high-intensity zone (HIZ) in anterior annulus fibrosus and assess the association of anterior HIZ with low back pain (LBP).
A retrospective study of 5,940 discs in 1,188 individuals was conducted.
Subjects' information and LBP symptoms confirmed by an orthopedic surgeon were acquired from the medical record. Magnetic resonance (MR) image reading and analysis were performed by two experienced blinded radiologists.
Two hundred eighty individuals exhibited 355 anterior HIZs in 355 discs. The prevalence was 23.57%; 88.45% were located in the inferior part of the annulus fibrosus. It frequently occurred in the middle and upper segments of lumbar spine, especially at L3/4 (45.63%). Of the 355 anterior HIZs, only 79 (22.25%) were consecutive-slides HIZ. Round type (63.38%) was the most common shape of anterior HIZs. The highest prevalence was found in individuals aged 60-69 years. LBP was confirmed in 141 anterior-HIZ individuals. The incidence of LBP in anterior-HIZ individuals was significantly higher than in non-HIZ subjects (50.36% vs 35.24%, χ2 = 18.314, P < 0.001).
Anterior HIZ is a lower-prevalence, age-related sign on lumbar MR images. The spatial distribution of anterior HIZ can be distinguished from posterior HIZ. The number of consecutive anterior HIZ slides might suggest fewer Dallas grade 4 anterior annular disruptions in this sample. Anterior HIZ was correlated with LBP.
Anterior HIZ is a lower-prevalence, age-related sign on lumbar MR images. The spatial distribution of anterior HIZ can be distinguished from posterior HIZ. The number of consecutive anterior HIZ slides might suggest fewer Dallas grade 4 anterior annular disruptions in this sample. Anterior HIZ was correlated with LBP.
Family structure in childhood influences early brain development and cognitive performance in adulthood. Much less is known about its long-term impact on later-life cognitive functioning. We extend the two-generation family structure approach to investigate the potential contribution of living with grandparents in multigenerational households to differences in cognitive functioning at older ages.
Data were drawn from nine waves of the Health and Retirement Study (1998-2014) merged with newly-collected childhood family history data. Five types of family structure were assessed two-parent households, two-parent households with grandparents, single-parent households, single-parent households with grandparents, and grandparent-headed households. Caerulein manufacturer Growth curve models were used to estimate trajectories of cognitive functioning over time.
Childhood family structure was significantly associated with level of cognitive functioning, but not to rate of cognitive decline. Relative to those from two-parent householdsincrease as the contemporary population ages. More research needs to be done to understand the impact of these living arrangements on future generations' brain health and cognitive aging.Perinatal early nutritional disorders are critical for the developmental origins of health and disease. Glycotoxins, or advanced glycation end-products, and their precursors such as the methylglyoxal, which are formed endogenously and commonly found in processed foods and infant formulas, may be associated with acute and long-term metabolic disorders. Besides general aspects of glycotoxins, such as their endogenous production, exogenous sources, and their role in the development of metabolic syndrome, we discuss in this review the sources of perinatal exposure to glycotoxins and their involvement in metabolic programming mechanisms. The role of perinatal glycotoxin exposure in the onset of insulin resistance, central nervous system development, cardiovascular diseases, and early aging also are discussed, as are possible interventions that may prevent or reduce such effects.
Higher fibroblast growth factor-23 (FGF23) concentrations are associated with heart failure and mortality in diverse populations, but the strengths of associations differ markedly depending up on which assay is used.
We sought to evaluate whether iron deficiency, inflammation, or kidney function account for differences in the strengths of associations between these 2 FGF23 assays with clinical outcomes.
Case cohort study from the Cardiovascular Health Study.
A total of 844 community-dwelling individuals aged 65 years or older with and without chronic kidney disease were followed for 10 years.
Outcomes included death, incident heart failure (HF), and incident myocardial infarction (MI). Exposure was baseline intact and C-terminal FGF23. Using modified Cox models, adjusting sequentially we tested whether observed associations of each assay with outcomes were attenuated by iron status, inflammation, kidney function, or their combinations.
FGF23 measured by either assay was associated with mortality in unadjusted analysis (intact FGF23 hazard ratio [HR] per 2-fold higher 1.
