Association of tensor fascia lata hypertrophy and fatty infiltration in the presence of abductor tendon tears: a radiographic study

ABSTRACT Hip abductor tendon tears of the gluteus medius and minimus are becoming a well-recognized source of pain and dysfunction, primarily in middle-age females. Like the rotator cuff, fatty infiltration (FI) can occur after tearing of these tendons. While the association of TFL hypertrophy after abductor tendon tears has been established, its association with FI has not been well studied. Our hypothesis is that hypertrophy of the TFL will be associated with FI of the abductors. All patients >18 years old undergoing primary surgical repair for a confirmed tears on MRI, without a history of prior hip surgery or osteoarthritis, were included. The following measurements were obtained from MRI: TFL cross-sectional area, TFL:sartorius volume ratio, and modified Goutallier grade of gluteus medius and minimus. Seventy patients met inclusion criteria and were divided in two groups, those with (n = 28) and those without FI (n = 42) of the abductors. The FI group was on average older (65 versus 58 years, P < 0.00016). TFL hypertrophy and TFL:sartorius volume ratio were significantly associated with FI (P= 0.00069). Following abductor tendon tear and subsequent FI, there exists significant TFL hypertrophy in patients without a prior history of hip surgery in our patient cohort.

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Arthroscopic Repair of the Hip Abductor Musculotendinous Unit: The Effect of Microfracture on Clinical Outcomes

The American Journal of Sports Medicine ◽

10.1177/0363546521999678 ◽

2021 ◽

pp. 036354652199967

Author(s):

Baris Kocaoglu ◽

Ahmet Emre Paksoy ◽

Simone Cerciello ◽

Matthieu Ollivier ◽

Romain Seil ◽

...

Keyword(s):

Clinical Outcomes ◽

Surgical Repair ◽

Gluteus Medius ◽

Arthroscopic Repair ◽

Harris Hip Score ◽

Level Of Evidence ◽

Outcome Score ◽

Significant Difference ◽

Hip Abductor ◽

Tendon Tears

Background: Endoscopic surgical repair has become a common procedure for treating patients with hip abductor tendon tears. Considering that retear rates are high after the repair of gluteus medius and minimus tendons, exploring alternative strategies to enhance structural healing is important. Purpose/Hypothesis: The purpose of this study was to evaluate the effect of adding microfracture to single-row repair (SR) on outcomes after the surgical repair of gluteus medius and minimus tendons and compare with SR and double-row repair (DR) without microfracture. We hypothesized that microfracture of the trochanteric footprint with SR would lead to superior clinical outcomes and lower clinically evident retear rates compared with SR and DR without the addition of microfracture. Study Design: Cohort study; Level of evidence, 3. Methods: A total of 50 patients who underwent primary arthroscopic repair of hip gluteus medius and minimus tendon tears were investigated. Patients were divided into 3 groups: DR, 16 patients; SR, 14 patients; and SR with microfracture (SRM), 20 patients. Patients were evaluated with a visual analog scale (VAS) for pain as well as the Hip Outcome Score–Activities of Daily Living (HOS-ADL), Hip Outcome Score–Sport Specific (HOS-SS), and modified Harris Hip Score (mHHS) both preoperatively and at a minimum 2-year follow-up (mean, 30 months). Results: Among the SR, SRM, and DR groups, the greatest decrease in VAS scores and increase in mHHS, HOS-ADL, and HOS-SS scores were seen in the SRM group, and all the differences were significant ( P < .001 to P = .006). The abductor tendon retear rates were 31.3%, 35.7%, and 15.0% in the DR, SR, and SRM groups, respectively. Retear rates were lower in the SRM group compared with the SR and DR groups ( P = .042); however, there was no significant difference between the SR and DR groups ( P = .32) in terms of retear rates. Conclusion: Endoscopic SR with microfracture was a safe, practical, and effective technique and had the potential advantage of enhancing biological healing at the footprint. The addition of microfracturing the trochanteric footprint significantly lowered the retear rate and provided better functional outcomes than SR and DR without microfracture.

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Abstract WP226: Short Lasting Runs (<30 sec) of Atrial Fibrillation are More Commonly Observed in Ischemic Stroke Patients in Comparison to Controls

Stroke ◽

10.1161/str.47.suppl_1.wp226 ◽

2016 ◽

Vol 47 (suppl_1) ◽

Author(s):

Ethem Murat Arsava ◽

Ezgi Yetim ◽

Ugur Canpolat ◽

Necla Ozer ◽

Kudret Aytemir ◽

...

Keyword(s):

Atrial Fibrillation ◽

Ischemic Stroke ◽

Multivariate Analyses ◽

Holter Monitoring ◽

Female Gender ◽

Prior History ◽

Consecutive Series ◽

Stroke Patients ◽

Cross Sectional ◽

History Of

Background: The role of short-lasting (<30 sec) runs of atrial fibrillation (AF) in ischemic stroke pathophysiology is currently unknown. Although these non-sustained attacks are considered as a risk factor for future development of longer lasting, classical AF episodes, prior research has highlighted that associated clinical stroke features are not entirely similar between these two types of arrhythmias. In this study we determined the prevalence of short-lasting AF in stroke-free controls and compared it to a consecutive series of ischemic stroke patients. Methods: A total 235 controls, without any prior history stroke or AF, were evaluated with ECG and 24-hour Holter monitoring for the presence of <30-sec or ≥30-sec lasting AF episodes. The results were compared to a consecutive series of ischemic stroke patients without prior history of AF (n=456). Univariate and multivariate analyses were performed to determine demographic and cardiovascular factors related to <30-sec lasting AF and its association with ischemic stroke. Results: Expectedly, the frequency of newly diagnosed ≥30-sec lasting AF, detected either on ECG or Holter monitoring, was significantly higher in patients with ischemic stroke (18% vs. 2%; p<0.01). Non-sustained AF was positively related to old age (p<0.01), female gender (p=0.01) and hypertension (p<0.01) in univariate analyses. In multivariate analyses, after adjustment for demographic and cardiovascular risk factors, presence of non-sustained AF was significantly higher among both cryptogenic (OR 1.78; 95% CI 1.02-3.10) and non-cryptogenic (OR 1.84; 95% CI 1.15-2.94) stroke patients with respect to controls. Conclusion: Our study shows a higher prevalence of non-sustained AF episodes in ischemic stroke patients in comparison to controls. Whether this cross-sectional association translates into causality in terms of stroke pathophysiology will be the subject of future studies.

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Comparison of gluteus medius strength between obese and eutrophic individuals: a cross-sectional study

10.21203/rs.2.24323/v3 ◽

2020 ◽

Author(s):

Rafael Ratti Fenato ◽

Allan Cezar Faria Araujo ◽

Ana Tereza Bittencourt Guimarães

Keyword(s):

Principal Component ◽

Gluteus Medius ◽

Great Difficulty ◽

Cross Sectional Study ◽

Normal Weight ◽

Cross Sectional ◽

Human Research Ethics ◽

Hip Abductor ◽

Lateral Decubitus ◽

Muscular Function

Abstract Background: The hip abductor muscles, primarily the gluteus medius, play an important role in stabilizing the pelvis during gait. Gluteus medius weakness is associated with biomechanical changes and musculoskeletal disorders. Obese individuals can have great difficulty maintaining abductor muscular function due to being overweight and possibly experiencing a decrease in muscle mass. However, it is still unclear whether the musculature of obese individuals can compensate for these changes. Therefore, the aim of this study was to compare gluteus medius strength between obese and normal-weight individuals using a digital hand-held dynamometer.Methods: Twenty-five obese (BMI > 35 kg/m2) participants were matched for sex, age, and height with normal-weight individuals. Gluteus medius strength was measured by a single examiner using a belt-stabilized hand-held digital dynamometer placed on the knee of the individuals positioned in lateral decubitus. Three measurements were recorded with rest intervals, and only the highest value measured for each limb was used for analysis. The differences between pairs were calculated, and the normality of the data was assessed using the Shapiro-Wilk test (p < 0.05). The matrices of the variables were standardized and analysed using principal component analysis (PCA).Results: For the strength variables (Newtons) on both sides, no significant differences were detected between the groups (p > 0.05). However, significant differences were detected in these variables between the groups (p < 0.05) when the measurements were normalized to body weight (Newtons/kilograms). PCA indicated that both the absolute and normalized values of strength are lower in obese than in normal-weight individuals.Conclusions: These findings indicate that obese individuals have the same or less strength (PCA) to move more mass, which may suggest a relative weakness that induces functional limitations.Trial registration: The study was approved by the UNIOESTE Human Research Ethics Committee (#1.180.202) in July 2015.

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Hepatitis C in pregnancy: an observational study highlighting its association with maternal parameters

International Journal of Research in Medical Sciences ◽

10.18203/2320-6012.ijrms20195941 ◽

2019 ◽

Vol 8 (1) ◽

pp. 344

Author(s):

Bushra . ◽

Ambreen Ghori ◽

Azra Ahmed ◽

Najma Dalwani ◽

Mushtaque Ali Shah ◽

...

Keyword(s):

Risk Factors ◽

Hepatitis C Virus ◽

Hepatitis C ◽

Previous History ◽

Cross Sectional Study ◽

University Hospital ◽

Prior History ◽

Singleton Pregnancy ◽

Cross Sectional ◽

History Of

Background: Pregnancy is a very crucial time in a woman’s life. In this period of time, not only multiple physiological alterations effect the usual health status but also makes women more vulnerable to contract infection and face negative sequalae. Hepatitis C, a blood borne viral infection serve the similar fate when encountered by pregnant ladies. This study is based on exploring the prevalence of the Hepatitis C virus seropositivity among pregnant population. Moreover, we also evaluated the major risk factors leading to the infection in these mothers. Besides this, infected mothers were studied for their pregnancy outcomes.Methods: In this study 114 pregnant females were observed for this cross-sectional study. It was conducted in Gynecology Unit- 1, Liaquat University Hospital Hyderabad, for the period of January 2017 to July 2017. Chi square test was applied for statistical analysis on SPSS version 16. The criteria for enrollment in the study was set to be a pregnant lady belonging to age group 20-35 years; having singleton pregnancy; was a booked case at the hospital with compliant to antenatal follow ups; admitted to the labor room for delivery. All the non-pregnant ladies, whom had co morbid conditions such as hypertension or diabetes or had infected with hepatitis B or D were excluded from the study. Furthermore, pregnant ladies with multiple gestion or those who were either diagnosed of hepatitis C prior to conceive or had a previous history of hepatitis C were also excluded.Results: Present study revealed that out of 114, 10(8.8%) pregnant ladies were found seropositive for Hepatitis C virus. Prior history for transfusion of blood was the Foremost risk factor discovered, with 60.5% women reported this. History of surgery was the 2nd commonest factor and 43.9% had this in their medical records. On the other hand, only 8.8% women gave the history for previous evacuation. While observing pregnancy outcomes, we found 48.2% neonates had low birth weight, 41.2% were born preterm and 21.1% had low APGAR score.Conclusions: In a nutshell hepatitis c is prevalent in the pregnant population of this region and showing its effects in the form of compromised pregnancies. History of blood transfusion and previous surgery were found to be chief risk factors in the study.

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A review of the anatomy of the hip abductor muscles, gluteus medius, gluteus minimus, and tensor fascia lata

Clinical Anatomy ◽

10.1002/ca.22004 ◽

2011 ◽

Vol 25 (6) ◽

pp. 697-708 ◽

Cited By ~ 55

Author(s):

Natasha Amy May Sparks Flack ◽

Helen D. Nicholson ◽

Stephanie Jane Woodley

Keyword(s):

Gluteus Medius ◽

Fascia Lata ◽

Tensor Fascia Lata ◽

Gluteus Minimus ◽

Hip Abductor ◽

Anatomy Of The Hip

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Neuroimaging utilization and findings in headache outpatients: Significance of red and yellow flags

Cephalalgia ◽

10.1177/0333102418758282 ◽

2018 ◽

Vol 38 (12) ◽

pp. 1841-1848 ◽

Cited By ~ 5

Author(s):

Nathan P Young ◽

Muhamad Y Elrashidi ◽

Paul M McKie ◽

Jon O Ebbert

Keyword(s):

Imaging Study ◽

Cross Sectional Study ◽

Prior History ◽

Community Practice ◽

Red Flags ◽

Cross Sectional ◽

History Of ◽

Red Flag ◽

Neuroimaging Study ◽

Yellow Flags

Background Neuroimaging for headache commonly exceeds published guideline recommendations and may be overutilized. Methods We conducted a retrospective cross-sectional study of all outpatient community patients at Mayo Clinic Rochester who underwent a neuroimaging study for a headache indication in 2015. We assessed the neuroimaging utilization pattern, clinical application of red flags, and concordance with neuroimaging guidelines. Results We identified 190 outpatients who underwent 304 neuroimaging studies for headache. The median age was 46.5 years (range 18–91 years), 65% were female, and most reported no prior history of headache (n = 97, 51%). A minority of patients had prior brain imaging studies (n = 44, 23%) and neurological consultations for headache (n = 29, 15%). Few studies were ordered after consultation with a neurologist (n = 14, 7%). Seventy-seven percent of patients were documented to have a “red flag” justifying the imaging study. Abnormal neuroimaging findings were found in 3.1% of patients with warning flags (5/161); carotid dissection (n = 3) and reversible cerebral vasoconstrictive syndrome (n = 2). An estimated 35% of patients were imaged against guidelines. Conclusions The prevalence of serious causes of headache in a community practice was low despite the presence of a documented red flag symptom. Inadequate understanding or application of red flags may be contributing to recommendations to image patients against current guidelines. Interventions to reduce unnecessary neuroimaging of patients with headache need to be designed and implemented.

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Hip Adduction and Abduction Torque-angle Curve Characterization of Speed Skating Athletes

International Journal of Sports Medicine ◽

10.1055/a-1073-7754 ◽

2020 ◽

Vol 41 (04) ◽

pp. 248-254

Author(s):

Luciano Luporini Menegaldo ◽

Lyon Aragão ◽

Thiago Matta ◽

Liliam Fernandes de Oliveira

Keyword(s):

Gluteus Medius ◽

Recovery Phase ◽

Control Group ◽

Tensor Fascia Lata ◽

Speed Skating ◽

Adductor Muscles ◽

Hip Abductor ◽

Torque Angle ◽

Similar Peak

Abstract Speed skating is a cyclic sport which involves the hip abductor muscles, impelling the participant forwards, and adductor muscles, in the recovery phase and decelerating the abduction movement eccentrically. This paper has the objective of describing and comparing the abduction/adduction torque-angle curves of speed skating athletes (N=10) with a group of non-practitioners young participants (N=10). Both groups presented similar peak torques and electromyography patterns for tensor fascia lata, gluteus medius, long adductor and adductor magnus. However, athletes showed higher torque-angle curve integral and abduction and adduction peak torques at different hip angles than the control group. These findings suggest an adaptation of their musculotendon actuators and a better capacity to generate mechanical work and power during a propulsion-recovery cycle.

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The Investigation of Tramadol Dependence with No History of Substance Abuse: A Cross-Sectional Survey of Spontaneously Reported Cases in Guangzhou City, China

BioMed Research International ◽

10.1155/2013/283425 ◽

2013 ◽

Vol 2013 ◽

pp. 1-6 ◽

Cited By ~ 10

Author(s):

Haoran Zhang ◽

Zhimin Liu

Keyword(s):

Substance Abuse ◽

Physical Dependence ◽

Abuse Potential ◽

Opiate Withdrawal ◽

Control Group ◽

Prior History ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Healthy Men ◽

History Of

The study was to survey and assess the drug dependence and abuse potential of tramadol with no history of substance abuse. Subjects of tramadol dependence with no prior history of substance abuse were surveyed by interview. Physical dependence of tramadol was assessed using 10 items opiate withdrawal scale (OWS), and psychological dependence was assessed by Addiction Research Center Inventory—Chinese Version (ARCI-CV). Twenty-three male subjects (the median age was23.4±4.1years) referred to the addiction unit in Medical Hospital of Guangzhou with tramadol abuse problems were included in this cross-sectional study. The control group included 87 heroin addicts, 60 methamphetamine (MA) abusers, and 50 healthy men. The scores of OWS of tramadol were 0.83–2.30; the mean scores of identifying euphoric effects–MBG, sedative effects–PCAG, and psychotomimetic effects–LSD of ARCI were8.96±3.08,6.52±3.25, and6.65±2.50, respectively,F= 4.927,P<0.001. Scores of MBG scale in tramadol did not differ from those in heroin and MA groups (P>0.05) but were higher than those in healthy men (P<0.05). Tramadol with no history of substance abuse has a clear risk of producing high abuse potential under the long-term infrequent abuse and the high doses.

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The effect of COVID-19 on medical students’ education and wellbeing: a cross-sectional survey

Canadian Medical Education Journal ◽

10.36834/cmej.71261 ◽

2021 ◽

Author(s):

Hassan ElHawary ◽

Ali Salimi ◽

Natasha Barone ◽

Peter Alam ◽

Stephanie Thibaudeau

Keyword(s):

Medical Students ◽

Online Survey ◽

Leisure Activities ◽

Prior History ◽

Cross Sectional Survey ◽

Health Habits ◽

Cross Sectional ◽

Canadian Medical School ◽

History Of

Background: Canadian medical school curriculums have undergone major restructuring during the COVID-19 pandemic. This study’s goal was to assess the perceived impact of COVID-19 on medical students’ education and wellbeing. Methods: An online survey was distributed to Canadian medical students. Descriptive analyses and ANOVAs were used to assess changes in mental health, health habits and quality of education during the pandemic. Results: 248 medical students from 13 schools across Canada participated in this study. 74% reported a reduction in the quality of their education since COVID-19. 58% of students found online to be inferior to in-person teaching. 65% of students had more time for wellness and leisure activities, about half of the cohort felt more depressed (48%) and lonelier (52%). Student’s overall health habits worsened after the start of the pandemic (F=37.4, p < 0.001). Alcohol drinking, time spent seated, and screen time also increased since the pandemic (p < 0.001). During the pandemic, students with a prior history of depression or anxiety expressed increased depressive symptoms (66% vs. 42%, p =0.003), increased anxiety (69% vs. 41%, p < 0001), worse sleep quality (34% vs. 18%, p = 0.031), and poorer quality of life (55% vs. 65%, p = 0.024) versus those with no prior history. Conclusion: Canadian medical student’s education and wellbeing has been negatively impacted during the pandemic.

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Factors Associated with Depression and Anxiety in the Adult Population of Qatar in the First Year of the COVID-19 pandemic: Results from an Online Survey

10.21203/rs.3.rs-729213/v1 ◽

2021 ◽

Author(s):

Salma M. Khaled ◽

Iman Amro ◽

Lina Bader ◽

Peter Woodruff ◽

Majid A Alabdulla ◽

...

Keyword(s):

Risk Factors ◽

Online Survey ◽

Adult Population ◽

Prior History ◽

First Year ◽

Depression And Anxiety ◽

Cross Sectional ◽

Factors Associated ◽

Potential Risk Factors ◽

History Of

Abstract Background: There is limited data from Arabic-speaking countries on risk factors for depression and anxiety during the COVID-19 pandemic. Country-specific data is necessary given differences in culture, demographics, COVID-19 infection and mortality rates.Aim: To identify factors associated with symptoms of depression-anxiety in the adult population of Qatar during the first year of the COVID-19 pandemic.Method: We conducted a cross-sectional online survey in Qatar between July and December 2020 after the first COVID-19 wave and before the beginning of the second wave. Depression-anxiety was defined as a cut-off of 20 or higher on the PHQ-ADS scale. Results: Of 1138 participants, 71.05% were female, 69.0% Arabs, and 70.0% Non-Qataris. 77% were < 40 years (the median age in Qatar is 32 years). In a fully-adjusted model, six variables were significantly associated with PHQ-ADS; Arab ethnicity (OR=1.67, p=0.026), never married (OR=2.04, p < 0.001 (versus married), prior history of psychiatric disorder (versus no history) (OR=1.76, p=0.039), increased worries due to social media use for COVID-related news/updates (OR=1.72, p=0.003), those with a history of COVID-19 (OR=1.76, p=0.039), loneliness (OR=1.91, p < 0.001), and lower levels of religiosity (OR=0.96, p=0.039). These associations also pertained in the reduced model, with exception of religiosity which was only marginally statistically significant (OR=0.97, p=0.055).Conclusions: The potential risk factors identified may assist with anxiety and depression prevention in future COVID-19 waves, and similar crises, and assist with early intervention to treat sufferers.

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