Burgesshealy7276

STUDY DESIGN Prospective radiographic study. OBJECTIVES To determine the three-dimensional (3D) changes in deformity correction with magnetically controlled growing rod (MCGR) distractions. MCGRs can achieve similar coronal plane correction as traditional growing rods. The changes in the sagittal and axial planes are unknown and should be studied as these factors reflect potential for proximal junctional kyphosis and rotational deformity. Frequent MCGR distractions may potentially improve axial plane deformities to the same extent as coronal and sagittal plane deformities. METHODS Early onset scoliosis (EOS) patients who underwent dual MCGRs with minimum 2-year follow-up were included in this study. 3D reconstructions of 6-monthly biplanar images were used to study changes in coronal, sagittal and axial planes. Changes in growth parameters (body height and arm span) were scaled to changes in coronal Cobb angles, sagittal profile (T1-12, T4-12, L1-L5, L1-S1), and rotational profile at the proximal thoracic, main thoracic and lumbar curves, and pelvic parameters (sagittal pelvic tilt, lateral pelvic tilt and pelvis rotation). RESULTS A total of 10 EOS patients were studied. The mean age at index surgery was 8.2 ± 3.0 years and mean postoperative follow-up of 34.3 ± 9.5 months. Six patients had rod exchange at mean 29.5 ± 11.8 months after initial implantation. Despite consistent gains in body height and arm span, the main changes in coronal and rotational profiles only occurred at the initial rod implantation surgery with only small changes occurring with subsequent follow-ups. Patients with higher preoperative proximal junctional angles had flattening of the sagittal plane occurring at initial surgery with early rebound. No changes in pelvic parameters were observed. CONCLUSIONS The 3D changes with MCGR are mainly observed with initial rod implantation and no significant changes are observed with distractions. The MCGR can prevent deformity progression in the axial plane. LEVEL OF EVIDENCE IV.STUDY DESIGN Cross-sectional comparative study. OBJECTIVES Evaluate prevalence and clinical relevance of an underlying pathology in painful adolescent idiopathic scoliosis (AIS) patients after a non-diagnostic history, physical examination and spinal X-ray using Magnetic Resonance Image (MRI) as diagnostic tool. Discrepancies regarding indications of routine MRI screening in painful AIS patients are multifactorial. Few studies have investigated relationship and practical importance of painful AIS with an underlying pathology by MRI. METHOD A total of 152-consecutive AIS patients complaining of back pain during a 36-month period were enrolled. All patients underwent whole-spine MRI after a non-diagnostic history, physical examination and spinal X-ray. Underlying pathologies were reported as neural and non-neural axis abnormalities based on MRI reports. Variables such as sex, age, constant or intermittent pain, night pain, back pain location (thoracic or lumbar pain), Cobb-angle and follow-up were evaluated as on must be performed by clinicians; and discussed with patients and family prior to undergo further imaging management. LEVEL OF EVIDENCE Level III.PURPOSE To evaluate the impact of proximal thoracic segment (T1-T5) on global thoracic kyphosis, as well as its influence on cervical alignment (lordotic, kyphotic or straight) in patients with adolescent idiopathic scoliosis (AIS). METHODS We conducted a retrospective study of 80 patients with AIS. The inclusion criteria were patients between 10 and 18 years of age with a posteroanterior (PA) and lateral full-length radiographs, excluding those subjected to surgery, orthotic treatment, with other spinal disease or with poor X-ray quality. The parameters evaluated were age, sex, pelvic incidence (PI), sacral slop (SS), pelvic tilt (PT), global sagittal balance (GSB), scoliotic curvatures (differentiated according to primary curve, lumbar modifier and sagittal modifier), cervical spine alignment, thoracic sagittal Cobb angle between T1 and T5, T5 and T12 and between T1 and T12. read more RESULTS In patients with AIS, the proximal sagittal thoracic Cobb segment, contrary to the distal, demonstrated a significant positive correlation with cervical spine alignment (p  less then  0.05). As there is an increase in proximal thoracic angle, there is an increase in cervical lordosis. We also demonstrated that the correlation between an increase in scoliotic curvature and a decrease in kyphosis only occurred in the distal thoracic segment (T5-T12). Relative to the spinopelvic parameters, the PI was not related with the dorsal kyphosis or shape of the cervical spine. CONCLUSIONS In AIS, proximal (T1-T5) and distal (T5-T12) thoracic kyphosis have different contributions on the global thoracic sagittal curvature and in the phenomenon of hypokyphosis. On the other hand, only the proximal segment is significantly related to the shape of the cervical spine. LEVEL OF EVIDENCE IV.STUDY DESIGN A retrospective analysis of a prospectively collected consecutive case series of patients with adult spinal deformity who underwent 3-column osteotomy (3-CO) with pelvic fixation. OBJECTIVES The objectives were to verify the effect of additional rods and determine the optimal type of additional rod for preventing rod fracture (RF). RF is a frequent complication following 3-CO surgery in patients with adult spinal deformity. Two types of additional rod constructs were utilized to prevent RF. METHODS We evaluated data retrieved from a prospectively collected single-center database. Patients were classified into two groups depending on rod constructs conventional 2-rod and 2-rod constructs with additional rods. The additional rod constructs were also stratified into two groups according to the location that they covered only osteotomy site (short additional rod) or osteotomy site and lumbosacral junction (long additional rod). RESULTS A total of 48 patients (average age 67.6 years; follow-up rate 90.6%; 2-rod 25 cases and additional rod 23 cases) were included. No significant difference was observed in age, fusion level, operation time, blood loss, and rod composition. The incidence of RF in the additional rods (36%) was significantly lower than that in the 2-rod constructs (68%). Comparing the additional rod constructs, RF occurred in 7 cases (64%) in short additional rod and 2 cases (17%) in long additional rod. RF occurred at the level below the additional rod construct in 6 of 7 RF cases with short additional rod. CONCLUSIONS Additional rods covering the osteotomy site and lumbosacral junction reduced the incidence of RF following 3-CO surgery with pelvic fixation in short term. LEVEL OF EVIDENCE 3.This study describes the utility of overnight sleep studies in children with early onset scoliosis (EOS). Children with EOS have diminished respiratory reserve which is associated with abnormal breathing and sleep quality in children. Currently, there are no criteria for referral of these children to evaluate breathing during sleep or data on the use of sleep treatments as part of their supportive care. A review of the 159 patients with EOS who were followed at a single institution from 2003 to 2016 identified 68 who underwent overnight polysomnograms (PSGs). Sixty-five of 68 (96%) had elevated apnea-hypopnea index (AHI) and a majority (56%) were prescribed nighttime respiratory support. A majority of young children ( less then  5 years) with PSG were referred for a history of snoring, apnea, or restless sleep; all 30 had abnormal PSGs. Twenty-seven (90%) had nighttime hypoxemia (nadir oxygen saturation values less then  92%). Eighteen (60%) were referred to otolaryngology, of whom 11 (37%) subsequently underwent tonsil and/or adenoid removal. In older children (≥ 5 years), those referred for PSGs had more severe restrictive chest wall disease [lower forced vital capacity (FVC) values] than those who were not sent for PSG. Correlation between FVC and apnea-hypopnea index, however, was not significant. Pre-operative coronal curve magnitude did not strongly correlate with nadir SaO2 or AHI in either age group. These results suggest that sleep studies are underutilized in the management of children with EOS. Inadequate and poor-quality sleep adversely affects growth, behavior, and cognitive function in children. This study suggests that screening for sleep abnormalities should be incorporated into assessment and treatment of more patients with EOS.Preventive care is a form of healthcare that aims to prevent diseases or detect diseases in an eary stage, especially for diseases like colorectal cancer. YouTube is a platform with great reach and opportunity to educate the public through preventive healthcare-related resources. However, understanding on current YouTube resources, specifically related to colorectal cancer screening, are inadequate in terms of informational quality. In this study, videos related to colorectal cancer and colorectal cancer screening were identified and analyzed by two reviewers. Very useful (4.5%), moderately useful (18.5%), somewhat useful (38.9%), and not useful (38.2%) videos were categorized based on a usefulness scale compiled by medical professionals. Less useful videos are paralleled with more views and public engagement in comparison with more useful videos which had been released by more credible sources. There is a significant association between video length and level of usefulness as well between video source and usefulness. This study illustrates the need for better educational healthcare resources and/or filtration on widely accessible platforms such as YouTube.BACKGROUND In the new era of publication, scientific misconduct has become a focus of concern including extreme variability of plagiarism, falsification, fabrication, authorship issues, peer review manipulation, etc. Along with, overarching theme of "retraction" and "predatory journals" have emphasized the importance of studying related infrastructures. METHODS Information used in this review was provided through accessing various databases as Google Scholar, Web of Science, Scopus, PubMed, Nature Index, Publication Ethics and Retraction Watch. Original researches, expert opinions, comments, letters, editorials, books mostly published between 2010 and 2020 were gathered and categorized into three sections of "Common types of misconduct"," Reasons behind scientific misconduct" and "Consequences". Within each part, remarkable examples from the past 10 years cited in Retraction Watch are indicated. At last, possible solution on combating misconduct are suggested. RESULTS The number of publications are on the draenomenon must be fully focused and fundamental alternation should be implemented in this regard.Myeloid differentiation factor 88 (MyD88) is an adaptor protein for the Toll-like receptor (TLR) and interleukin 1 receptor (IL-1R) families of innate immunity receptors that mediate inflammatory responses to cellular injury. TLR/IL1R/MyD88 signaling is known to contribute to retinal degeneration, although how MyD88 regulates neuronal survival, and the effect of MyD88 on the inflammatory environment in the retina, is mostly unknown. In this study, we tested the hypothesis that blocking MyD88-mediated signaling early in retinal degeneration promotes transition of microglia towards a neuroprotective anti-inflammatory phenotype, resulting in enhanced photoreceptor survival. We also tested whether systemic delivery of a pharmacologic MyD88 inhibitor has therapeutic potential. The rd10 mouse model of retinal degeneration was injected intraperitoneally with increasing doses of a MyD88 blocking peptide or control peptide early in degeneration, and inflammatory responses and photoreceptor survival were measured at specific time points using flow cytometry, cytokine profiling, and electroretinograms.