Branchthorpe1387

The COVID-19 pandemic was severely aggravated in Brazil due to its politicization by the country's federal government. However, the impact of diffuse political forces on the fatality of an epidemic is notoriously difficult to quantify. Here we introduce a method to measure this effect in the Brazilian case, based on the inhomogeneous distribution throughout the national territory of political support for the federal government. This political support is quantified by the voting rates in the last general election in Brazil. This data is correlated with the fatality rates by COVID-19 in each Brazilian state as the number of deaths grows over time. We show that the correlation between fatality rate and political support grows as the government's misinformation campaign is developed. This led to the dominance of such political factor for the pandemic impact in Brazil in 2021. Once this dominance is established, this correlation allows for an estimation of the total number of deaths due to political influence as 350±70 thousand up to the end of 2021, corresponding to (57±11)% of the total number of deaths.Patients who underwent distal radius fracture (open reduction and internal fixation [ORIF]) at a Level 1 trauma center deemed "overlapping" (greater than 30 minutes overlap) were compared against consecutive cases. Unplanned return to surgery within 1 year was the primary outcome. Sixty-two patients were included in the overlapping group and 37 in the consecutive group. There was no difference in unplanned return to surgery 1 year following procedure with three cases (5%) in the overlapping group and one case (3%) in the consecutive group. There was a significant difference (p = 0.02) in procedure time between the overlapping group (151 + 54 minutes) and nonoverlapping group (126 + 35 minutes). There was no difference in infection, readmission, nonunion, malunion, deep infection, or superficial infection between groups. Based on a post-hoc power analysis with p less then 0.05 and power at 80%, 2,691 patients would be needed to determine if there is truly no difference between groups. (Journal of Surgical Orthopaedic Advances 31(2)127-130, 2022).Pectoralis major tendon injuries are an uncommon injury. They can be treated with primary repair, however, when the tendon becomes retracted it necessitates tendon reconstruction. We performed a systematic review to evaluate patient characteristics, surgical techniques, and outcomes associated with pectoralis major reconstruction. A review was performed for studies published between 1990 and 2019. Peer-reviewed studies with a minimum 1-year follow-up were included. Return to activity, range of motion, complications, and functional outcome scores were primary outcomes. Fourteen primary studies with 88 total patients met inclusion criteria. All patients were male with the average age of 34.6 years-old. Hamstring autograft represented the most frequently used graft type (35). Functional outcomes demonstrated good to excellent results in the majority of patients. Pectoralis major tendon reconstruction is a viable option for tears not amenable to primary repair. We found good to excellent outcomes, and 94.2% return to sport for patients undergoing reconstruction. (Journal of Surgical Orthopaedic Advances 31(2)123-126, 2022).Proximal humerus fractures represent one of the most common fractures in the elderly, and are increasingly treated with surgical fixation. Suture augmentation attaching the rotator cuff to the plate has been advocated to combat varus collapse and other associated complications. The objective of this study was to evaluate the contribution of rotator cuff augmentation to stability of proximal humerus fracture fixation. Twelve shoulder specimens from six cadavers underwent simulated two-part and three-part proximal humerus fractures. Matched specimens from the same cadaver were randomized to suture augmentation with locking plate fixation vs. locking plate fixation alone. Greater tuberosity fragment displacement was recorded during cyclic rotational strain of the glenohumeral joint. Greater tuberosity displacement in the two-part fracture model trended towards greater motion without suture augmentation, but did not reach statistical significance (0.032 + 0.012 mm vs. 0.213 + 0.109 mm, p = 0.130). In the three-part fracture model, there was a statistically significant decrease in fracture displacement in the presence of suture augmentation (0.068 + 0.025 mm vs. 2.392 + 0.373 mm, p less then 0.001). No specimens demonstrated premature failure during cyclic loading. Suture augmentation of locking plate fixation of three-part proximal humerus fractures results in decreased fracture displacement than locked plating alone, during rotational stresses simulating in vivo rotator cuff deformation forces. (Journal of Surgical Orthopaedic Advances 31(2)119-122, 2022).Prophylactic radiotherapy (XRT) is a commonly used treatment to decrease heterotopic ossification (HO) in patients with traumatic hip injuries. We conducted a retrospective review of patients at risk for HO who underwent XRT. Of the patients reviewed, 27.3% developed radiographic HO, 11.2% developed symptoms, and 2.0% required resection surgery. Patients were divided into primary (n = 71) and secondary prophylaxis (n = 27) cohorts. In the primary group, 25.0% developed radiographic HO, 5.6% developed symptoms, and 0 required surgery. https://www.selleckchem.com/products/pqr309-bimiralisib.html In the secondary cohort, 33.3% of patients developed new radiographic HO, and 25.9% were symptomatic four had a Brooker score of 3, and three had a score of 4 (p = 0.03), and 7.4% required surgical resection. (Journal of Surgical Orthopaedic Advances 31(2)113-118, 2022).The purpose of this study was to quantify the impact of low-fidelity simulation on resident surgical skills education. Fourteen orthopaedic surgery residents (PGY-1 through PGY-5) were separated into two, training-level-matched cohorts - an untrained control cohort (UCC) and a low-fidelity Sawbones training cohort (SAW). Together, both cohorts received didactic instruction on the soft-tissue approach, intra-operative reduction, internal-fixation, and surgical wound closure of Schatzker II tibial plateau fractures. The SAW cohort first rehearsed open-reduction, internal-fixation on radiopaque Sawbones models (Pacific Research Laboratories Inc. Vashon, WA). Both cohorts were then evaluated while performing the same procedure on high-fidelity cadaveric models (Rimasys GmbH Cologne, Germany). Surgical skill and knowledge were assessed using the objective structured assessment of technical skills (OSATS) tool, a written exam, and an after-action survey. There were no significant differences in OSATS scores or written exam scores between the two cohorts. A near-linear positive relationship (R2 = 0.9737) existed between training year and average overall OSATS score. All residents expressed a preference for surgical skills training with high-fidelity cadaveric models. The results of this study fail to demonstrate a training advantage of low-fidelity Sawbones models when surgical skill is measured on high-fidelity cadaveric models. Despite this, residents across both cohorts qualitatively felt the high-fidelity models offered a better educational opportunity for surgical practice than did the low-fidelity Sawbones models. (Journal of Surgical Orthopaedic Advances 31(2)109-112, 2022).Proximal humerus fractures (PHF) are common in elderly and osteoporotic patients, and these fractures are often described using the Neer classification. As reverse shoulder arthroplasty (RSA) for PHF becomes more common, it is helpful to identify the utility of Neer classification in predicting postoperative outcomes for patients undergoing RSA. The medical records of patients undergoing primary RSA for PHF at a single academic institution from 2013-2019 were identified using medical billing codes. A multivariable logistic regression analysis identified independent factors associated with all cause 90-day readmissions, reoperation, and length of stay (LOS) greater than three days. Fifty-five patients (average age of 72.3 ± 8.6 years) were included. No statistically significant differences among two-, three-, and four-part fractures with regard to LOS, discharge location, 90-day readmission, revision surgery, postoperative dislocation, or deep infection were detected. These findings suggest that Neer classification for PHF is not predictive of short-term complications after RSA. (Journal of Surgical Orthopaedic Advances 31(2)104-108, 2022).This study aims to compare perioperative events following total knee arthroplasty (TKA) amongst various degrees of preoperative opioid use. In total, 84,569 patients undergoing TKA were identified from a Humana Claims Dataset, and stratified by their preoperative opioid use based on number of prescriptions filled within 6 months of surgery (naïve 0 [50,561]; sporadic 1 [12,411]; chronic 2 or greater [21,687]). Outcomes of interest included Center for Medicare and Medicaid Services (CMS)-reportable complications, need for postoperative supplemental oxygen, 90-day readmission, and hospital length of stay. Complication rates (9.8% vs 8.9% vs 12.6%; p less then 0.01), need for supplemental oxygen (3.0% vs 3.1% vs 5.3%; p = 0.03), mean length of stay (2.1 vs 2.8 vs 3.5; p less then 0.01), and 90-day readmission (9.7% vs 10.8% vs 16.4%; p less then 0.01) significantly differed amongst groups. On logistic regression, only the chronic opioid use group was associated with significantly increased likelihood of complications, need for supplemental oxygen, and readmission. (Journal of Surgical Orthopaedic Advances 31(2)100-103, 2022).Conservative treatment of adhesive capsulitis fails in up to 30% of patients. Manipulation under anesthesia (MUA) has been shown to be safe and effective, although complications (iatrogenic fracture, glenohumeral dislocation, rotator cuff tears, nerve injuries) have been reported. This study details a novel technique, FEAR (Forward elevation, Extension, Adduction/abduction, and internal and external Rotation), and its results. Medical records review identified 100 patients with a diagnosis of adhesive capsulitis who had at least 6 weeks of physical therapy, with or without corticosteroid injection, with persistence of pain and loss of motion loss. An Institutional Review Board approved phone survey obtained Single Assessment Numeric Evaluation (SANE) scores, visual analog scale (VAS) scores, functional scores, and range of motion, with 43 available for survey. At average 5-year follow-up, 81% had excellent (≥ 90) scores and 77% were pain-free. Patients with diabetes and male patients had significantly lower SANE scores at follow-up. (Journal of Surgical Orthopaedic Advances 31(2)096-099, 2022).The purpose of this study was (1) to determine how much emphasis is placed on the Personal Statement (PS) by program directors (PDs) and (2) to gain a better understanding of what factors within the PS are considered most important to PDs. An anonymous survey was distributed to PDs at allopathic orthopaedic residency programs in the United States using Survey Monkey (San Mateo, CA). Survey responses were received from 51 of 152 (34%) PDs. Forty-five (88.2%) identified as male, five (9.8%) identified as female, and one (1.9%) chose not to disclose. PDs reported the PS was of average importance, with an average score of 2.82 (range,1-4). Although the PS is still given consideration as part of the overall orthopaedic surgery residency application process, it does not play a major role in determining which applicants will be invited for an interview or how they will be ranked. (Journal of Surgical Orthopaedic Advances 31(2)090-095, 2022).