scholarly journals Evaluation of the Feasibility of a Telemedical Examination of the Hip and Pelvis – Early Lessons from the COVID-19 Pandemic

2020 ◽  
Author(s):  
Max Jaenisch ◽  
Hendrik Kohlhof ◽  
Amadeo Touet ◽  
Michael Kehrer ◽  
Davide Cucchi ◽  
...  
Keyword(s):  
Range Of Motion ◽  
Hip Joint ◽  
Significant Positive Correlation ◽  
Trauma Surgery ◽  
Patient Specific ◽  
Positive Correlation ◽  
Asa Classification ◽  
Classification Score ◽  
Specific Factors ◽  
Adequate Agreement

Abstract Introduction Due to the current COVID-19 pandemic, the German Health Ministry has issued restrictions applying to the field of orthopaedics and trauma surgery. Besides postponement of elective surgeries, outpatient consultations have been drastically reduced. Parallel to these developments, an increase in telemedical consultations has reflected efforts to provide sufficient patient care. This study aims to evaluate the feasibility of a clinical examination of the hip joint and pelvis by way of a telemedical consultation. Materials and Methods Twenty-nine patients of a German university clinic were recruited and assessed in both telemedical and conventional examinations. Agreement between the two examinations was then assessed, and connections between the observed agreement and patient-specific factors such as age, BMI and ASA classification were investigated. Results The inspections agreed closely with a mean Cohenʼs kappa of 0.76 ± 0.37. Palpation showed adequate agreement with a mean Cohenʼs kappa of 0.38 ± 0.19. Function showed good agreement with a mean Cohenʼs kappa of 0.61 ± 0.26 and range of motion showed adequate agreement with a mean Cohenʼs kappa of 0.36 ± 0.19. A significant positive correlation was observed between the number of deviations in the different examinations and age (p = 0.05), and a significant positive correlation was shown between the number of non-feasible examinations and age (p < 0.01), BMI (p < 0.01) and ASA classification score (p < 0.01). Discussion Inspection and function can be reliably evaluated, whereas the significance of palpation, provocation and measurement of range of motion is limited. The small sample size puts limitations on the significance of a statistically relevant correlation between patient-specific factors such as age, BMI and ASA classification score and valid and successful implementation of a telemedical examination. The authors recommend targeted patient selection. If, however, patients are being evaluated who are very old (> 75 years), obese (BMI > 30) or with multiple comorbidities (ASA 3 and above), caution is advised. Large, prospective studies are needed in the future to fully validate telemedical consultations in the fields of orthopaedics and trauma surgery. Conclusion A telemedical examination of the hip joint and pelvis can be performed with certain limitations. Patient-specific factors such as age, BMI, and extent of comorbidities appear to have a relevant impact on validity and execution of the examination. Patients with multiple comorbidities (ASA 3 and above), advanced age (> 75 years) or obesity (BMI > 30) should, whenever possible, be examined in a conventional outpatient setting.

scholarly journals Causes and Clinical Impact of Loss to Follow-Up in Patients with Proliferative Diabetic Retinopathy

2020 ◽  
Vol 2020 ◽  
pp. 1-8
Author(s):  
Hazem Abdelmotaal ◽  
Walid Ibrahim ◽  
Mohamed Sharaf ◽  
Khaled Abdelazeem
Keyword(s):  
Diabetic Retinopathy ◽  
Proliferative Diabetic Retinopathy ◽  
Significant Positive Correlation ◽  
Clinical Impact ◽  
Patient Specific ◽  
Loss To Follow Up ◽  
Positive Correlation ◽  
Link Type ◽  
Anti Vegf

Purpose. This study determined the clinical impact and causes of loss to follow-up (LTFU) from the patients’ perspective in individuals with proliferative diabetic retinopathy (PDR) who received panretinal photocoagulation (PRP) and/or intravitreal injections (IVIs) of antivascular endothelial growth factor (VEGF). Methods. This prospective cohort study included 467 patients with PDR who received PRP and/or IVIs of anti-VEGF between May 2013 and June 2018. LTFU was defined as missing any follow-up visit for any interval exceeding 6 months, provided that patients eventually resumed care. Main outcome measures include rates and causes of LTFU. Results. A total of 391 patients (83.7%) were followed up, and 76 patients (16.3%) were LTFU over the study period. Rates of LTFU decreased with age (P=0.005). Questionnaire analysis conducted for patients’ LTFU showed a significant positive correlation between best corrected visual activity (BCVA) loss and patient’s lack of trust and satisfaction with treatment (rs = 0.458, P<0.001). There was also a significant positive correlation between treatment unaffordability and number of IVIs of anti-VEGF (rs = 0.55, P<0.001) and lack of social support and age (rs = 0.39, P<0.001). Conclusions. LTFU threatens vision in PDR patients receiving PRP and/or IVIs of anti-VEGF. Possibly, patient-specific LTFU causes should be addressed before treatment in order to minimize the risk of LTFU. The clinical trial is registered with NCT04018326 (trial registration: ClinicalTrials.gov Identifier: NCT04018326, 10th of July 2019 “Retrospectively registered”).

scholarly journals Correlates of SARS-CoV-2 Variants on Deaths, Case Incidence and Case Fatality Ratio among the Continents for the Period of 1 December 2020 to 15 March 2021

Genes ◽  
2021 ◽  
Vol 12 (7) ◽  
pp. 1061
Author(s):  
Wajdy J. Al-Awaida ◽  
Baker Jawabrah Al Hourani ◽  
Samer Swedan ◽  
Refat Nimer ◽  
Foad Alzoughool ◽  
...  
Keyword(s):  
Negative Correlation ◽  
Significant Positive Correlation ◽  
Vaccine Development ◽  
Case Fatality ◽  
Significant Negative Correlation ◽  
Reference Sequence ◽  
Genome Sequences ◽  
Positive Correlation ◽  
Case Fatality Ratio ◽  
Epidemiological Surveys

The outbreak of coronavirus disease 2019 (COVID-19), by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has quickly developed into a worldwide pandemic. Mutations in the SARS-CoV-2 genome may affect various aspects of the disease including fatality ratio. In this study, 553,518 SARS-CoV-2 genome sequences isolated from patients from continents for the period 1 December 2020 to 15 March 2021 were comprehensively analyzed and a total of 82 mutations were identified concerning the reference sequence. In addition, associations between the mutations and the case fatality ratio (CFR), cases per million and deaths per million, were examined. The mutations having the highest frequencies among different continents were Spike_D614G and NSP12_P323L. Among the identified mutations, NSP2_T153M, NSP14_I42V and Spike_L18F mutations showed a positive correlation to CFR. While the NSP13_Y541C, NSP3_T73I and NSP3_Q180H mutations demonstrated a negative correlation to CFR. The Spike_D614G and NSP12_P323L mutations showed a positive correlation to deaths per million. The NSP3_T1198K, NS8_L84S and NSP12_A97V mutations showed a significant negative correlation to deaths per million. The NSP12_P323L and Spike_D614G mutations showed a positive correlation to the number of cases per million. In contrast, NS8_L84S and NSP12_A97V mutations showed a negative correlation to the number of cases per million. In addition, among the identified clades, none showed a significant correlation to CFR. The G, GR, GV, S clades showed a significant positive correlation to deaths per million. The GR and S clades showed a positive correlation to number of cases per million. The clades having the highest frequencies among continents were G, followed by GH and GR. These findings should be taken into consideration during epidemiological surveys of the virus and vaccine development.

scholarly journals Comparative Evaluation of Adenoids, Upper Airway, and Tongue Using “Predictors of Difficult Airways” in Class II Division 1 and Division 2 Cases with Class I Cases: Prospective In Vivo Observational Study

2021 ◽  
pp. 030157422096341
Author(s):  
Smita Mangesh Choudhari ◽  
Sunita Shrivastav
Keyword(s):  
Significant Positive Correlation ◽  
Upper Airway ◽  
Class Ii ◽  
Class I ◽  
Positive Correlation ◽  
Division 1 ◽  
Difficult Airways ◽  
Mandibular Protrusion ◽  
Division 2 ◽  
Class Ii Division 1

Introduction: Altered nasorespiratory function leads to altered craniofacial growth. Thus, airway evaluation is important for preventive, interceptive, and corrective orthodontic treatment. The aim of this study was to evaluate and compare adenoids, the upper airway, the tongue, and mandibular dimensions using “predictors of difficult airways” in class II division 1 and class II division 2 cases with class I cases. Method: Sixty subjects of age 15 to 18 years were divided into 3 groups (group 1: class I cases; group 2: class II division 1 cases; and group 3: class II division 2 cases) based on cephalometric parameters, with 20 cases in each group. Cephalometric evaluation of adenoids and the nasopharyngeal airway was done using the Handelman–Osborne area method. Upper and lower airway evaluation was done using McNamara’s linear method. “Predictors of difficult airways” were used for evaluation of the airway, which included nasal competency, the Mallampati scale, mandibular length, mandibular protrusion, and the thyromental distance. Results: The present study found a significant positive correlation between the grades of nasal competency and percentage adenoid wall area, and a significant negative correlation between the grades of nasal competency and the upper airway. There was a significant positive correlation between the grades of nasal competency and mandibular length, and a significant positive correlation between the grades of mandibular protrusion and mandibular length. There was a significant positive correlation between the grades of the thyromental distance and mandibular length. Conclusion: It was concluded that the “predictors of difficult airways” would be helpful in early diagnosis and identification of potential risk factors that may cause “breathing disorders”–related malocclusions and later on increase the risk of developing OSA.

scholarly journals An MRI-Based Patient-Specific Computational Framework for the Calculation of Range of Motion of Total Hip Replacements

2021 ◽  
Vol 11 (6) ◽  
pp. 2852
Author(s):  
Maeruan Kebbach ◽  
Christian Schulze ◽  
Christian Meyenburg ◽  
Daniel Kluess ◽  
Mevluet Sungu ◽  
...  
Keyword(s):  
Range Of Motion ◽  
Internal Rotation ◽  
Computer Aided Design ◽  
External Rotation ◽  
Patient Specific ◽  
Computational Framework ◽  
Total Hip ◽  
Total Hip Replacements ◽  
Significant Difference ◽  
Hip Replacements

The calculation of range of motion (ROM) is a key factor during preoperative planning of total hip replacements (THR), to reduce the risk of impingement and dislocation of the artificial hip joint. To support the preoperative assessment of THR, a magnetic resonance imaging (MRI)-based computational framework was generated; this enabled the estimation of patient-specific ROM and type of impingement (bone-to-bone, implant-to-bone, and implant-to-implant) postoperatively, using a three-dimensional computer-aided design (CAD) to visualize typical clinical joint movements. Hence, patient-specific CAD models from 19 patients were generated from MRI scans and a conventional total hip system (Bicontact® hip stem and Plasmacup® SC acetabular cup with a ceramic-on-ceramic bearing) was implanted virtually. As a verification of the framework, the ROM was compared between preoperatively planned and the postoperatively reconstructed situations; this was derived based on postoperative radiographs (n = 6 patients) during different clinically relevant movements. The data analysis revealed there was no significant difference between preoperatively planned and postoperatively reconstructed ROM (∆ROM) of maximum flexion (∆ROM = 0°, p = 0.854) and internal rotation (∆ROM = 1.8°, p = 0.917). Contrarily, minor differences were observed for the ROM during maximum external rotation (∆ROM = 9°, p = 0.046). Impingement, of all three types, was in good agreement with the preoperatively planned and postoperatively reconstructed scenarios during all movements. The calculated ROM reached physiological levels during flexion and internal rotation movement; however, it exceeded physiological levels during external rotation. Patients, where implant-to-implant impingement was detected, reached higher ROMs than patients with bone-to-bone impingement. The proposed framework provides the capability to predict postoperative ROM of THRs.

Changes in duplex ultrasound parameters during maturation according to arteriovenous access types in incident hemodialysis patients

2021 ◽  
pp. 112972982110052
Author(s):  
Jae Jin Lee ◽  
Sun Ryoung Choi ◽  
Eun Ju Lee ◽  
Ha Youn Yang ◽  
Seon Ha Baek ◽  
...  
Keyword(s):  
Pulsatility Index ◽  
Significant Positive Correlation ◽  
Duplex Ultrasound ◽  
Hemodialysis Patients ◽  
Hemodynamic Parameters ◽  
Positive Correlation ◽  
Arteriovenous Access ◽  
Artery Flow ◽  
Ultrasound Parameters ◽  
Av Graft

Background: Little is known about the changes in hemodynamic parameters during arteriovenous (AV) access maturation using duplex ultrasound according to radiocephalic fistula (RCF), brachiocephalic fistula (BCF), and AV graft (AVG) in incident hemodialysis (HD) patient. The objective of this study was to evaluate changes and differences in brachial artery flow rate (BAFR) and related parameters affecting maturation by duplex ultrasound in incident HD patients according to access type. Methods: This study was an observational study conducted from March 2019 to October 2020. During the study period, 109 incident patients underwent new AV access creation, of which 100 were included in the study. The duplex ultrasound was performed on the day prior to access creation, further, day 1, 2 weeks, and 4 weeks later after access creation in incident HD patients. Results: Among all the patients, 38 (38%) received BCF, while 26 (26%) underwent RCF. Of the patients with AVG, 18 (50%) had a forearm loop AVG. The overall mean age was 62.2 ± 13.8 years (range, 32–89). The BAFR increased about 6.9 times in the RCF, 17.4 times in the BCF, and 19.5 times in the AVG at day 1. The median BAFR measured on day 1 was 580.4 mL/min for RC, 1029.0 mL/min for BC, and 1133.0 mL/min for AVG. Relative to the values measured in week 4, the BAFR on day 1 was 69.5% in RCF, 90.6% in BCF, and 93.9% in AVG. The acceleration decreased most significantly on day 1( p < 0.05). The acceleration time increased significantly on day 1 ( p < 0.05) and beyond during maturation in the RCF and BCF. The BAFR of the RCF had a significantly negative correlation with the pulsatility index. The BAFR of the BCF showed a significantly positive correlation with the systolic and diastolic blood pressure but negatively correlated with pulse rate. The BAFR of the AVG showed a significant positive correlation with the diameter of the outflow vein. Conclusions: There were differences in the clinical and duplex parameters during maturation according to access type. The most dramatic changes of duplex parameters were on the day after AV access creation regardless of AV access types. Though RCF had a lower BAFR rate compared to BCF and AVG, it already had a sufficient BAFR required for adequate HD treatment the day after creation. The BAFR of BCF was not different from that of AVG.

Relationship Between Gas Emissions and Dry Matter Intake in Mature Angus Cows

2021 ◽  
Vol 99 (Supplement_2) ◽  
pp. 32-33
Author(s):  
Amanda Holder ◽  
Megan A Gross ◽  
Alexi Moehlenpah ◽  
Paul Beck
Keyword(s):  
Dry Matter ◽  
Significant Positive Correlation ◽  
Crossover Design ◽  
Dry Matter Intake ◽  
Data Set ◽  
Gas Emissions ◽  
Positive Correlation ◽  
Wide Range ◽  
Carbon Dioxide Co2 ◽  
Second Period

Abstract The objective of this study was to examine the effects of diet quality on greenhouse gas emissions and dry matter intake (DMI). We used 42 mature, gestating Angus cows (600±69 kg; and BSC 5.3±1.1) with a wide range in DMI EPD (-1.36 to 2.29). Cows were randomly assigned to 2 diet sequences forage-concentrate (FC) or concentrate-forage(CF) determined by the diet they consumed in each period (forage or concentrate). The cows were adapted to the diet and the SmartFeed individual intake units for 14 d followed by 45 d of intake data collection for each period. Body weight was recorded on consecutive weigh days at the beginning and end of each period and then once every two wk for the duration of a period. Cows were exposed to the GreenFeed Emission Monitoring (GEM) system for no less than 9 d during each period. The GEM system was used to measure emissions of carbon dioxide (CO2) and methane (CH4). Only cows with a minimum of 20 total &gt;3-m visits to the GEM were included in the data set. Data were analyzed in a crossover design using GLIMMIX in SASv.9.4. Within the CF sequence there was a significant, positive correlation between TMR DMI and CH4 (r=0.81) and TMR DMI and CO2 (r=0.69), however, gas emissions during the second period on the hay diet were not correlated with hay intake. There was a significant, positive correlation between hay DMI and CO2 (r=0.76) and hay DMI and CH4 (r=0.74) when cows first consumed forage (FC). In comparison to the CF sequence, cows on the FC sequence showed a positive correlation between CO2 and TMR DMI during the second period. There was also a significant positive correlation between hay and TMR DMI when assessed across (r=0.43) or within sequence (FC r=0.41, CF r=0.47).

scholarly journals Radio-adaptive response and correlation of non-homologous end joining repair gene polymorphisms [XRRC5 (3R/2R/1R/0R), XRCC6(C/G) and XRCC7 (G/T)] in human peripheral blood mononuclear cells exposed to gamma radiation

2021 ◽  
Vol 43 (1) ◽  
Author(s):  
Shridevi Shelke ◽  
Birajalaxmi Das
Keyword(s):  
Dna Damage ◽  
Mrna Expression ◽  
Adaptive Response ◽  
Gene Polymorphisms ◽  
Significant Positive Correlation ◽  
Human Pbmcs ◽  
Mrna Expression Level ◽  
Repair Gene ◽  
Positive Correlation ◽  
Nhej Repair

Abstract Background Radio-adaptive response (RAR) is transient phenomena, where cells conditioned with a small dose (priming) of ionizing radiation shows significantly reduced DNA damage with a subsequent high challenging dose. The role of DNA double strand break repair gene polymorphism in RAR is not known. In the present study attempt was made to find out the influence of NHEJ repair gene polymorphisms [a VNTR; XRCC5 (3R/2R/1R/0R); two single nucleotide polymorphisms (SNPs); XRCC6 (C/G) and XRCC7 (G/T)] with DNA damage, repair and mRNA expression in human PBMCs in dose and adaptive response studies. Genomic DNA extracted from venous blood samples of 20 random healthy donors (16 adaptive and 4 non-adaptive) and genotyping of NHEJ repair genes was carried out using PCR amplified length polymorphism. Results The dose response study revealed significant positive correlation of genotypes at XRRC5 (3R/2R/1R/0R), XRCC6(C/G) and XRCC7 (G/T) with DNA damage. Donors having genotypes with 2R allele at XRCC5 showed significant positive correlation with mRNA expression level (0R/2R: r = 0.846, P = 0.034; 1R/2R: r = 0.698, P = 0.0001 and 2R/2R: r = 0.831, P = 0.0001) for dose response. Genotypes C/C and C/G of XRCC6 showed a significant positive correlation (P = 0.0001), whereas, genotype T/T of XRCC7 showed significant negative correlation (r = − 0.376, P = 0.041) with mRNA expression. Conclusion Interestingly, adaptive donors having C/G genotype of XRCC6 showed significantly higher (P < 0.05) mRNA expression level in primed cells suggesting their role in RAR. In addition, NHEJ repair gene polymorphisms play crucial role with radio-sensitivity and RAR in human PBMCs.

scholarly journals Evaluation of serum adropin and irisin levels and its association with anthropometric obesity indices and biochemical parameters in Type 2 diabetic patients

2021 ◽  
pp. 1-8
Author(s):  
Foad Alzoughool ◽  
Huda Al Hourani ◽  
Manar Atoum ◽  
Sajedah Bateineh ◽  
Hanan Alsheikh ◽  
...  
Keyword(s):  
Negative Correlation ◽  
Biochemical Parameters ◽  
Significant Positive Correlation ◽  
Glycosylated Hemoglobin ◽  
Significant Negative Correlation ◽  
Diabetic Patients ◽  
Positive Correlation ◽  
Obesity Indices ◽  
Group Serum

BACKGROUND/AIM: The newly described proteins adropin and irisin are a highly conserved polypeptide that plays essential roles in metabolic and energy homeostasis, insulin resistance, and fat browning. The aim of this study is to evaluate the circulating levels of serum adropin and irisin in type 2 diabetes mellitus (T2DM) patients and also to elucidate possible relationships between serum adropin and irisin levels with anthropometric obesity indices and biochemical parameters. SUBJECTS AND METHODS: Single-center prospective observational study included 90 T2DM patients referred to the diabetes outpatient clinic. Height, weight, and waist circumference (WC) were measured. Body mass index (BMI) and waist to height ratio (WHtR) were calculated. Fasting blood glucose, glycosylated hemoglobin, serum lipids, creatinine, urea, and blood urea nitrogen were evaluated. Estimated glomerular filtration rate (GFR) was calculated, serum adropin and irisin were evaluated. RESULTS: The results showed a significant positive correlation between adropin and irisin in females but not in males (r = 0.311; P = 0.042). In males’ group, serum adropin levels showed significant negative correlation with serum glucose (–0.423, P = <  0.05), HbA1C (–0.364, P = <  0.05), and GFR (–0.355, P = <  0.05). In contrast, creatinine was showed a significant positive correlation with adropin in males (0.381, P = <  0.05). In females’ group, adropin showed a significant negative correlation with weight (–0.371, P = <  0.05), BMI (–0.349, P = <  0.05), WC (–0.402, P = <  0.01), and WHtR (–0.398, P = <  0.01). Contrary, in males’ group, serum irisin levels showed significant positive correlation with weight (0.338, P = <  0.05), BMI (0.332, P = <  0.05), WC (0.409, P = <  0.01), and WHtR (0.432, P = <  0.01). CONCLUSION: This study demonstrated that, in T2DM patients, circulating serum adrpoin correlated negatively with anthropometric obesity indices of obesity in females, while serum irisin was positively correlated with anthropometric obesity indices of obesity in males.

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