Blackholdt2059
Bilateral injuries are generally addressed from both sides of the pelvis. This article describes the surgical technique of 3D image-guided transsacral screw fixation for unilateral and bilateral nondisplaced sacral insufficiency fractures in the elderly using a single-sided approach, and specifies the associated preoperative and postoperative management. The procedure is illustrated in an instructional video that demonstrates step-by-step, how the navigated surgical procedure is performed.
This was a retrospective study.
This study investigates the influence of physical function and their influence on postoperative depressive symptom scores as measured by Patient Health Questionnaire-9 (PHQ-9) among anterior cervical decompression and fusion (ACDF) patients.
While ACDF is one of the most commonly performed ambulatory surgeries, research is limited on the predictive value of Patient-Reported Outcomes Measurement Information System (PROMIS) scores and their influence on depressive symptoms as measured by the PHQ-9.
A prospectively maintained surgical registry was retrospectively reviewed from March 2016 to January 2019. Inclusion criteria were primary or revision ACDF procedures. Patients were grouped by preoperative PROMIS score (≥35.0, <35.0), with higher scores indicating greater physical function. The χ2 and Student t tests assessed categorical and continuous variables (eg, demographics, perioperative, and postoperative values). A t test evaluated postoperative improvement in PROMIly. This suggests that many patients experience multidimensional health benefits after ACDF procedures.
Individuals with lower preoperative PROMIS PF scores had significantly higher PHQ-9 scores at 1 year. Patients with lower preoperative physical function, as evaluated by PROMIS PF scoring, had greater improvement of mental health at 1 year postoperatively. This suggests that many patients experience multidimensional health benefits after ACDF procedures.
This was a retrospective cohort review.
The objective of this study was to determine the rate of fusion associated with an expandable cage and iliac crest bone graft in minimally invasive transforaminal lumbar interbody fusion (MI-TLIF) surgery.
MI-TLIF is a commonly performed procedure, but challenges inherent in MI-TLIF technique can make achieving an interbody fusion difficult.
A retrospective review was performed on consecutive patients treated with an MI-TLIF for degenerative lumbar pathology. Patients that completed patient-reported outcome measures and 1-year computed tomography (CT)-scans for fusion analysis were included. Fusion morphology was analyzed by evaluating CT scans for location of bridging trabecular bone in relation to the cage. Patients with bridging bone were considered fused. Preoperative and postoperative health-related quality of life scores were compared. A Kolmogrov-Smirnoff test was used to determine normality of health-related outcome scores. A Friedman 2-way analysis of vimproved fusion rates without graft-site complications in MI-TLIF surgery.
Combining an expandable cage with iliac crest autograft bone harvested through a minimally invasive technique can allow for improved fusion rates without graft-site complications in MI-TLIF surgery.
This was a retrospective study.
The objective of this study was to evaluate whether the anatomy of the left common iliac vein (LCIV) affects the radiologic outcomes in oblique lateral interbody fusion (OLIF) at L5-S1.
Upward mobilization and retraction of the LCIV is an essential technique in OLIF at L5-S1. However, mobilization of the LCIV is sometimes difficult and may affect the surgical outcomes in OLIF at L5-S1.
This study involved 52 consecutive patients who underwent OLIF at L5-S1 and had >1-year regular follow-up. The configuration of LCIV on preoperative axial magnetic resonance images of the lumbar spine was categorized into 3 types according to the difficulty of mobilization type I (no requirement for mobilization), type II (potentially easy mobilization), and type III (potentially difficult mobilization). Radiologic parameters included anterior/posterior disk heights (ADH/PDH), disk angle (DA), cage migration, cage subsidence, cage position, and fusion rate at L5-S1. Intraoperative/peri, type III LCIV patients had a high rate of intraoperative vascular injury.
The aim of this study is to evaluate whether the exposure to a low dose of Nickel could determinate a variation in levels of progesterone in outdoor workers.
261 subjects were divided by gender, task, age, seniority and cigarette smoking habit. For each workers was evaluated the dose of blood progesterone and urinary nickel.The statistical analysis was performed.
The Pearson correlation showed a statistically significant correlation between urinary nickel levels and progesterone. The Multiple linear regression showed a significant correlation between progesterone and urinary nickel in the total sample and in the subgroups of smokers and workers with tasks of traffic direction.
The results of our study suggest that occupational exposure to low doses of nickel present in urban pollution may influence to progesterone levels in outdoor workers.
The results of our study suggest that occupational exposure to low doses of nickel present in urban pollution may influence to progesterone levels in outdoor workers.
To explore employees' intentions to improve lifestyle habits, investigate the health and lifestyle-related predictors of these intentions, and how it translated into behavioral improvement.
Employees participating in the Activate Your Health WHPP completed a questionnaire of their demographics, health-related variables, as well as six lifestyle habits and intention to improve them.
At baseline (n = 2729), most employees wanted to focus on physical activity and eating habits. Many predictors were identified for each intention. Majority of intentions were associated with behavioral improvement post-program (n = 526), especially in High.
In the context of WHPPs, intention to improve may lead to actual behavioral improvement. Exploring employees' intentions to improve various lifestyle habits at the start of the program could improve the effectiveness of these programs.
In the context of WHPPs, intention to improve may lead to actual behavioral improvement. Exploring employees' intentions to improve various lifestyle habits at the start of the program could improve the effectiveness of these programs.
The present work compares various methods for using baseline cognitive performance data to predict eventual cognitive status of longitudinal study participants at the University of Kentucky's Alzheimer's Disease Center.
Cox proportional hazards models examined time to cognitive transition as predicted by risk strata derived from normal mixture modeling, latent class analysis, and a 1-SD thresholding approach. An additional comparator involved prediction directly from a numeric value for baseline cognitive performance.
A normal mixture model suggested 3 risk strata based on Consortium to Establish a Registry for Alzheimer's Disease (CERAD) T scores high, intermediate, and low risk. Cox modeling of time to cognitive decline based on posterior probabilities for risk stratum membership yielded an estimated hazard ratio of 4.00 with 95% confidence interval 1.53-10.44 in comparing high risk membership to low risk; for intermediate risk membership versus low risk, the modeling yielded hazard ratio=2.29 and 95% confidence interval=0.98-5.33. Latent class analysis produced 3 groups, which did not have a clear ordering in terms of risk; however, one group exhibited appreciably greater hazard of cognitive decline. All methods for generating predictors of cognitive transition yielded statistically significant likelihood ratio statistics but modest concordance statistics.
Posterior probabilities from mixture modeling allow for risk stratification that is data-driven and, in the case of CERAD T scores, modestly predictive of later cognitive decline. Incorporating other covariates may enhance predictions.
Posterior probabilities from mixture modeling allow for risk stratification that is data-driven and, in the case of CERAD T scores, modestly predictive of later cognitive decline. Incorporating other covariates may enhance predictions.Nurse call data may be used to evaluate the quality of nursing. However, traditional frequency-based statistics may not easily apply to nurse calls due to the large individual variability and daily call changes. We intended to propose a probabilistic modeling of nurse calls based on Bayesian statistics. We constructed the model including nurse call daily changes, individual variability, and adjustment according to characteristics (age and sex). Nurse call differences after surgery were analyzed based on data from the orthopedic ward from April 2014 to October 2017. Results show that there were differences in nurse calls from day 1 to day 10 after surgery between patients who had undergone orthopedic surgery and those who had undergone other surgeries such as tumor surgery. Furthermore, there were differences in nurse calls from day 1 to day 8 after surgery between patients who used extra pain relief medicine and those who did not. Although the analysis required multiple comparisons regarding daily nurse call changes and fixed data samples per day, our approach using Bayesian statistics could detect the periods and significant differences. This indicates that our nurse call modeling based on Bayesian statistics may be used to analyze nurse call changes.Pharmacogenetics, a subset of precision medicine, provides a way to individualize drug dosages and provide tailored drug therapy to patients. This revolution in prescribing techniques has resulted in a knowledge deficit for many healthcare providers on the proper way to use pharmacogenetics in practice. This research study explored the potential adoption of clinical decision support system mobile apps by clinicians through investigating the initial usability of the PGx prototype application in an effort to address the lack of such tools used in practice. The study method included usage of a clinical decision support system programmed within our pharmacogenomics drug dosage application (called PGx) in a simulated environment. Study participants completed the System Usability Scale survey to report on the perceived usefulness and ease of use of the mobile app. The PGx app has a higher perceived usability than 85% of all products tested, considered very good usability for a product. This general usability rating indicates that the nurse practitioner students find the application to be a clinical decision support system that would be helpful to use in practice.Traditional methods for research study recruitment such as snail mail lists and posting flyers may fail to reach the tech-savvy participants needed for today's healthcare studies. Word of mouth can be effective for recruiting a few participants but can rarely accomplish the numbers needed for a representative sample. Social media can be a viable avenue to reach increased numbers of sample participants; however, a good understanding of the risks and benefits of using social media is needed before embarking on active recruitment. A recent study developed an evidence-based participant recruitment plan for the use of Facebook. Potential participant misrepresentation was addressed with clear inclusion criteria, no incentives, and open-ended questions. The Facebook ads to recruit study participation targeted licensed nurses who worked in the prior 2-year period living in the United States based on information in Facebook user profiles. A total of 536 participants responded to all questions on the survey at a cost of $1.
