Mcwilliamsfitzpatrick5914

The median procedure time was 189.5 minutes. The median fluoroscopy time was 0.9 minutes, with eight (67%) patients receiving no fluoroscopy at all. click here Recurrence occurred in one patient (8%) over a median follow-up duration of 16 months (interquartile range 12.8-17.3 months). No adverse periprocedural events were recorded. This study suggests the use of high-density electroanatomic mapping in adult CHD patients showed potential for rapid acquisition of highly detailed maps with minimal fluoroscopy time or risk of periprocedural events in the studied population.Background Osteoporotic vertebral compression fractures (OVCF) due to severe and refractory back pain or neurological complications require surgical treatment. In this study, patients with radiculopathy due to foraminal stenosis following OVCF were surgically managed by performing transforaminal full-endoscopic lumbar foraminoplasty and/or discectomy (FELFD). Methods From May 2015 to November 2019, fifteen patients underwent transforaminal FELFD. Patient data, Charlson comorbidity index (CCI), and American Society of Anesthesiologists (ASA) score were collected. Clinical outcomes, including pre- and postoperative Visual Analog Scale (VAS) scores for back and leg pain, Oswestry Disability Index (ODI), and MacNab criteria of response to surgical treatment, were evaluated. link2 Results Mean of age, bone mineral density (T-score), CCI, ASA, and follow-up duration were 69.5 ± 6.6 years, -2.6 ± 0.8, 5.2 ± 2.3, 2.4 ± 0.5, and 24.5 ± 8.8 months, respectively. Mean VAS for leg pain significantly decreased from 6.9 ± 0.8 preoperatively to 2.9 ± 1.1 (P less then .05). Mean ODI decreased from 39.9 ± 3.2 preoperatively to 19.3 ± 4.6 postoperatively (P less then .05). The satisfaction rate is 86.7% (based on Macnab criteria), showed six patients had excellent outcomes and seven had good outcomes. Conclusions Transforaminal FELFD is an effective treatment option for patients with radiculopathy due to lumbar OVCF, including those with severe osteoporosis and elderly patients.

Venous thromboembolic events (VTEs) are common after total knee arthroplasty (TKA). The rate of VTEs has improved with early mobilization, mechanical prophylaxis, and appropriate chemoprophylaxis. The aim of this study was to analyze the contribution of medical comorbidities to the risk of VTE after TKA.

Medicare claims from 2005 to 2014 were queried. link3 International Classification of Diseases, Ninth revision (ICD-9), and Current Procedural Terminology codes were used to identify the diagnoses, procedures, and complications. 157,200 primary TKAs were age, sex, and Elixhauser Comorbidity Index (ECI) matched with 157,200 osteoarthritis controls. First instances of deep venous thrombosis (DVT) and pulmonary embolism were tracked at 90 days and 2 years. Odds ratios (ORs), confidence intervals, and

-values (p) were calculated and used to investigate the contribution of comorbidities.

90 days after TKA or OA diagnosis, comorbidities were associated with 45% of the DVT risk, 38% of the PE risk. 1 in 92 patients would be expected to be diagnosed with VTE after TKA and 1 in 136 patients after only the diagnosis of osteoarthritis. After 90 days, medical comorbidities were associated with 70% of the DVT risk, 68% of the PE risk.

Nearly 50% of DVTs and 40% of PEs within 90 days of TKA may be related to the baseline health of OA patients. Venous thromboembolic events after TKA are a "never" event according to Center of Medicare and services that appropriate VTE prophylaxis likely cannot be neutralized.

Nearly 50% of DVTs and 40% of PEs within 90 days of TKA may be related to the baseline health of OA patients. Venous thromboembolic events after TKA are a "never" event according to Center of Medicare and services that appropriate VTE prophylaxis likely cannot be neutralized.

Proximal humeral fractures (PHFs) account for 4-5% of all fractures in the elderly. There is still a controversy among the treatments in the displaced PHFs. Our aim was to explore the clinical outcome of PHFs with the treatment of MultiLoc nail or Philos plate in the elderly patients.

A total of 82 sustained elderly patients with PHFs were finally recruited between Dec 2016 and Dec 2017. 34 patients were treated with MultiLoc nail and 48 patients were treated with Philos plate. The demographics, fracture types, blood loss, operation time, union time, postoperative complications, visual analog scores (VASs), Constant scores, American Shoulder and Elbow Scores (ASESs), and neck-shaft-angle (NSA) between the two groups were compared.

No differences were observed in the demographics, fracture types, VAS, Constant scores, and ASES scores between the two groups at final follow-up. Compared with the plate group, the blood loss, operation time, and union time were significantly lower in the nail group (all

&the change of NSA.

During the last decades, the growing number of shoulder replacement has increased the associated complications. Periprosthetic fractures have a low incidence but can be a severe clinical condition, especially in elderly population. There are still no guidelines to define the best treatment protocol for post-operative periprosthetic humeral fractures. Factors associated to these fractures and consequently the decision-making for the best treatment seem to be patient-related but also correlated with the type of implant. The aim of this study is to analyze the patient's risk factors, fracture pattern, implant type and treatment, evaluating the outcome with a long-term follow-up.

A retrospective study was performed on more than 2700 shoulder prostheses implanted over 10years in two specialized centers, identifying 19 patients who underwent surgery for post-operative periprosthetic fracture. Gender, age, comorbidities, type of prosthetic implant, type of fracture, and cortical index of each patient were evaluated. All patients underwent surgery and were evaluated with a mean follow-up of 5years with radiographic controls and functional assessment with the Constant-Murley score.

Complete healing was achieved in 18 of 19 patients. All patients presented a lower Constant-Murley score than the pre-fracture score, there were no significant differences between prosthetic implants, and the cortical index was lower than the threshold level in more than 60% of cases.

The results of this study showed that a correct preoperative planning is essential to evaluate the type of implant and possible signs of stem mobilization. With a stable stem, it is preferable to maintain it and proceed to a synthesis. The decision process is more complex in periprosthetic fractures with a reduced cortical index, when some radiolucency lines are present in stems with high primary stability, because it is not always indicative of an unstable stem.

Therapeutic III.

Therapeutic III.Background The use of risk stratification tools in identifying high-risk hip fracture patients plays an important role during treatment. The aim of this study was to compare our locally derived Combined Assessment of Risk Encountered in Surgery (CARES) score with the the American Society of Anesthesiologists physical status (ASA-PS) score and the Deyo-Charlson Comorbidity Index (D-CCI) in predicting 2-year mortality after hip fracture surgery. Methods and Material A retrospective study was conducted on surgically treated hip fracture patients in a large tertiary hospital from Jan 2013 through Dec 2015. Age, gender, time to surgery, ASA-PS score, D-CCI, and CARES score were obtained. Univariate and multivariable logistic regression analyses were used to assess statistical significance of scores and risk factors, and area under the receiver operating characteristic (ROC) curve (AUC) was used to compare ASA-PS, D-CCI, and CARES as predictors of mortality at 2 years. Results 763 surgically treated hip fracture patients were included in this study. The 2-year mortality rate was 13.1% (n = 100), and the mean ± SD CARES score of surviving and demised patients was 21.2 ± 5.98 and 25.9 ± 5.59, respectively. Using AUC, CARES was shown to be a better predictor of 2-year mortality than ASA-PS, but we found no statistical difference between CARES and D-CCI. A CARES score of 23, attributable primarily to pre-surgical morbidities and poor health of the patient, was identified as the statistical threshold for "high" risk of 2-year mortality. Conclusion The CARES score is a viable risk predictor for 2-year mortality following hip fracture surgery and is comparable to the D-CCI in predictive capability. Our results support the use of a simpler yet clinically relevant CARES in prognosticating mortality following hip fracture surgery, particularly when information on the pre-existing comorbidities of the patient is not immediately available.

Vitamin A deficiency (VAD) in children is still a global public health problem, which needs continuous monitoring and timely intervention.

What is already known on this topic? Vitamin A deficiency (VAD) in children is still a global public health problem, which needs continuous monitoring and timely intervention.What is added by this report? Using surveillance data from China Nutrition and Health Surveillance of Children and Lactating Mothers in 2016-2017, the prevalence of VAD and marginal deficiency was 0.96% and 14.71%, respectively. The vitamin A nutritional status of children and adolescents from urban areas and those aged 12-17 years were better than those from rural areas and aged 6-11 years.What are the implications for public health practice? Marginal VAD was a major form of VAD in Chinese children. The monitoring of vitamin A status in key populations should be continuously strengthened, and the public should be encouraged to consume foods rich in vitamin A or vitamin A supplements.

Both lean and obese women carry a risk for adverse pregnancy outcomes. Correct self-perception of body weight status is necessary for optimal weight control.

What is already known about this topic? Both lean and obese women carry a risk for adverse pregnancy outcomes. Correct self-perception of body weight status is necessary for optimal weight control.What is added by this report? Data from the Nutrition and Chronic Disease Surveillance of Chinese Residents in 2015 were used in this study. The weight status and self-perception of weight among women of childbearing age in China were analyzed to provide basic data for improving the nutritional health of women of childbearing age.What are the implications for public health practice? Around 45% of women of childbearing age misperceive their body weight status. Future actions to improve body weight perception in women of childbearing age are necessary to increase the impact of public health campaigns focusing on a healthy body weight.

Low level energy and macronutrient intakes and dietary imbalances are still important issues and should be prioritized in children aged 6-11 years old in China.

What is already known on this topic? Low level energy and macronutrient intakes and dietary imbalances are still important issues and should be prioritized in children aged 6-11 years old in China.What is added by this report? Among children aged 6-11 years in China in 2016-2017, the average protein intake was 55.2 g/d in urban areas and was higher than the estimated 45.4 g/d in rural areas. The proportions of children whose protein intake were below the estimated average requirement (EAR) were about one-fifth in urban areas, and more than one-third in rural areas, respectively.What are the implications for public health practice? The undernutrition problem had changed into a nutritional imbalance problem among children aged 6-11 years in China. In addition to enriching the food supply and improving the dietary behavior, societies, schools, and families should make joint efforts to develop a feasible and appropriate dietary environment.