Müller-Weiss Disease: The Descriptive Factors of Failure Conservative Treatment

Background: Conservative treatment is the first-line approach for Müller-Weiss disease (MWD). However, factors associated with the failure of conservative treatment have never been reported. Our objectives were to compare the differences in demographic and radiographic parameters between “successful” and “failure” conservative treatment in patients with MWD and identify descriptive factors associated with failure conservative treatment. Methods: We retrospectively reviewed 68 patients with MWD divided into 29 “failure” and 39 “successful” conservative treatment groups. Demographic characteristics, Foot and Ankle Outcome Score (FAOS), visual analog scale (VAS) scores for pain and walking disability, and radiographic parameters such as calcaneal pitch, lateral Meary, anteroposterior (AP) Meary angle, and talonavicular-naviculocuneiform arthritis were compared. Logistic regression analysis was performed to identify descriptive factors of failure conservative treatment. A P value <.05 was considered a statistically significant difference. Results: We found more severe VAS pain and walking disability scores and FAOS for the pain, activities of daily living, and quality of life subscales in the failure group ( P < .05). Regression analysis demonstrated 2 significant descriptive factors associated with failure conservative treatment: abducted AP Meary angle >13.0 degrees and radiographic talonavicular arthritis. No demographic characteristics were found to be associated with failure conservative treatment. Conclusion: Midfoot abduction (AP Meary angle, >13 degrees) and radiographic talonavicular arthritis were factors associated with failure conservative treatment in MWD and should be determined concurrently with the clinical severity. Classification systems for MWD should include these factors. Level of evidence: Level III, retrospective comparative study.

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TO COMPARE THE EFFECTIVENESS OF NEBULISATION WITH ADRENALINE, 3% HYPERTONIC SALINE AND NORMAL SALINE IN BRONCHIOLITIS IN CHILDREN OF 2 TO 24 MONTHS OF AGE BASED ON CLINICAL SEVERITY SCORE AND NEBULISATION FREQUENCY.

International Journal of Medical and Biomedical Studies ◽

10.32553/ijmbs.v5i2.1764 ◽

2021 ◽

Vol 5 (2) ◽

Author(s):

Priyanka Jain ◽

Rakesh Jain

Keyword(s):

Hypertonic Saline ◽

Normal Saline ◽

Mean Difference ◽

Clinical Severity ◽

Research Centre ◽

P Value ◽

College Hospital ◽

Mean Values ◽

Significant Difference ◽

The Mean

Background & Method: We conducted a double blinded study at Index Medical College Hospital & Research Centre, Indore. The sample size was determined to be minimum of 120 cases as based upon previous years admission due to acute bronchiolitis. Initially, 146 cases were included in the study out of which 23 cases dropped out of the study after giving consent by guardian for participation in the study as they left against medical advice from the hospital. Result: The mean difference of CSS between 0 minutes to 60 minutes of nebulisation between groups in all cases was 0.4 ± 0.6, between 60 minutes and 4 hours was 0.8 ± 0.6, between 4 to 8 hours was 0.7 ± 0.6, between 8-12 hours was 0.6 ± 0.4, between 12-24 hours was 1.6 ± 0.9 and between 24-48 hours was 1.9 ± 0.9.The mean values and resultant p-value of ANOVA of various nebulising agents used for improvement in CSS shows significant association between various nebulising agents used along with improvement in CSS at the end of assessment at 48 hours of treatment. Conclusion: This study was conducted to establish the efficacy of each nebulisation agent (i.e. adrenaline, 3% hypertonic saline and normal saline) currently used and compare the outcomes as there is not enough evidence amongst Indian population on level of efficacy of each drug in causing improvement in symptoms and signs in various severities of bronchiolitis in early childhood. Comparison of significant improvement in mean difference in CSS at various intervals in all cases compared between groups by post hoc test revealed non-significant difference (p-value 0.700) between 3% hypertonic saline and normal saline. Keywords: nebulisation, adrenaline, bronchiolitis & clinical.

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The Effect of “High-ankle Sprain” Taping on Ankle Syndesmosis Congruity: A Cadaveric Study

The Open Sports Sciences Journal ◽

10.2174/1875399x02013010123 ◽

2020 ◽

Vol 13 (1) ◽

pp. 123-128

Author(s):

Stéphanie Lamer ◽

Jonah Hébert-Davies ◽

Vincent Dubé ◽

Stéphane Leduc ◽

Émilie Sandman ◽

...

Keyword(s):

Ankle Sprain ◽

Weight Bearing ◽

Axial Loading ◽

Cadaveric Study ◽

P Value ◽

Level Of Evidence ◽

Parametric Data ◽

Custom Made ◽

Significant Difference ◽

High Ankle Sprain

Background: Different treatment options exist for dynamically unstable purely ligamentous syndesmotic injury, including surgery, walking boot, brace and taping. Objective: The main purpose of this study was to evaluate the effect of high-ankle sprain taping (ring taping) on syndesmotic stability in various ligament conditions when axial loading is applied. Methods: This controlled cadaveric laboratory study included ten cadaveric specimens installed in a custom-made device applying 750N of axial loading in order to simulate weight-bearing. Sectioning of syndesmotic ligaments, AiTFL and IOL, was done sequentially and CT scan images were taken with and without high-ankle sprain taping. A validated measurement system consisting of 3 lengths and 1 angle was used. Results were compared with Wilcoxon tests for paired samples and non-parametric data. Results: In every ligament condition (intact vs. cut), no statistically significant difference was observed between specimens, with or without high-ankle sprain taping and with or without axial loading. When the data from ankles with AiTFL and IOL ruptures were compared, the mean for length “b” without axial loading was 7.19 (±2.17), compared to 7.20 (±1.98) with axial loading (p-value = 0.905). With taping and the leg still in axial loading, the value was 7.17 (±2.09) (p-value = 0.721), which is not statistically significant. Conclusion: It is impossible to conclude regarding high-ankle sprain taping’s capacity to maintain syndesmosis congruity because no significant difference was observed, regardless of condition. The most important finding is that high-ankle sprain taping did not cause malreduction of the injured syndesmosis. Level of Evidence: Level V cadaveric study

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Ultrasound-Guided Aspiration Does Not Reduce the Recurrence Rate of Ganglion Cysts of the Wrist

Journal of Wrist Surgery ◽

10.1055/s-0038-1668156 ◽

2018 ◽

Vol 08 (02) ◽

pp. 100-103 ◽

Cited By ~ 2

Author(s):

Gregory Kurkis ◽

Albert Anastasio ◽

Marijke DeVos ◽

Michael Gottschalk

Keyword(s):

Recurrence Rate ◽

Ultrasound Guidance ◽

Ganglion Cyst ◽

High Recurrence Rate ◽

P Value ◽

Ultrasound Guided ◽

Recurrence Rates ◽

Level Of Evidence ◽

Ganglion Cysts ◽

Significant Difference

Background Ganglion cysts are the most frequent soft tissue tumor encountered in the upper extremity and are commonly treated by aspiration or by surgical excision. Ultrasound is a promising addition to traditional aspiration, as it allows for visualization of the needle within the ganglion before aspiration. Questions Are ganglion cysts of the wrist less likely to reoccur if they are aspirated under ultrasound guidance versus “blind” aspiration without the use of ultrasound guidance? Does patient functionality change based on whether or not the cyst recurred? Patients and Methods In total, 52 patients were successfully contacted and recurrence rates were compared between those whose cyst was treated with ultrasound-guided (13 patients) with those whose cyst was treated with blind aspiration (39 patients). Mean follow-up time was 2.9 years. Results Recurrence rates were 69% (9 patients) and 74% (29 patients) for the ultrasound-guided and blind aspiration groups, respectively (p-value: 0.73), showing no significant difference in recurrences of wrist ganglion between the two groups. A metric of functionality (Quick–DASH [Disabilities of the Arm, Shoulder, and Hand]) revealed worse outcomes in patients who experienced return of ganglion cyst after aspiration versus those who did not. Conclusion Additional studies with improved sample sizes are needed to demonstrate the superiority of ultrasound-guided aspiration versus blind aspiration. Due to a high recurrence rate following aspiration (both ultrasound-guided and blinded), a lower threshold for surgical intervention is likely reasonable. Level of Evidence This is a Level IIIb study.

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Quality of Life for Children with Cystic Fibrosis in Gaza Strip

10.47363/jbbr/2020(2)114 ◽

2020 ◽

pp. 1-13

Author(s):

Yaser Hamdouna ◽

Keyword(s):

Quality Of Life ◽

School Performance ◽

Emotional Health ◽

Clinical Severity ◽

P Value ◽

Common Disease ◽

Organ Systems ◽

Significant Difference ◽

Study Population

Background: CF is a chronic, multisystem genetic disease with a wide variability in clinical severity. CF is a disease of exocrine gland function that involves multiple organ systems but chiefly results in chronic respiratory infections, pancreatic enzyme insufficiency, and associated complications in untreated patients. Many studies explained the lower QOL among adults with CF. in GS there is no previous studies concerned with measuring QOL among CF children Aim of the Study: The aim of this study was to assess the QOL among children with CF. Methodology: The study was descriptive, analytical and cross sectional studies. The study involves all 36 children with CF (less than 12 years old) who attained CF friends center; community based center in Gaza. The researchers uses the questionnaire which included demographic & illness related variables and Quality of life domains (physical, emotional, social and school). Reliability coefficient for the questionnaire was good (Cronbach alpha =0.833). Results and Conclusion: About 61% of the study population were males and 39% were females. Approximately 47% of them were less than 9 years and 53% were more than 9 years. About 41.7% of the study population from Gaza, 25.0% from middle zone, 13.9% from Rafah, 11.1% from Khanyounis and 8.3% from North of Gaza. Housing classification was 38.9%, 33.3% and 27.8 % for property house, renting house and family house respectively. Most of their parents had low educational levels and the majority of them were unemployed and have a monthly income less than 1200 NIS. About 61% of them have another sibling with CF. the majority of them receive Creon at a regular basis. The most common disease associated with them was Respiratory problem with 43.2%, 38.3% had gastrointestinal disease, 14.8% had heart disease and 3.7% had Diabetes Mellitus. The overall perception of the children regarding QOL was low (55%). The social functions was the highest (61.6%), physical functions (55.2%), school function (50.6%), and emotional function (48.8%). The result presented below show that no significant difference in QOL between socio-demographic data (p-value > 0.05) except the difference for QOL between age groups) p-value =0.001). Children older than 9 years old (2.95±0.3) have QOL more than children under nine years of age (2.53±0.4) and this difference was statistically significant as (P value = 0.02 < 0.05). It is also clear that QOL in males are more than female but this difference was not statistically significant. There is a positive correlation with a highly significant difference between QOL and the 4 domains and between domains with each other. Social performance was high correlated with school performance (r = 0.706) while the lowest correlation was between physical and school performance with no significant (p-value =0.065). Recommendations: The study recommend the importance of initiating a program to enhance the QOL for children with CF and focusing on the emotional health for those children as it was the least one perceived.

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THE INFLUENCE OF ACE I/D GENE POLYMORPHISM IN AMATEUR AMERICAN FOOTBALL ATHLETES IN BRAZIL

Revista Brasileira de Medicina do Esporte ◽

10.1590/1517-869220192506198909 ◽

2019 ◽

Vol 25 (6) ◽

pp. 460-463

Author(s):

Gino Fellipe Santoro ◽

Katlyn Duarte de Mello ◽

Zair Cândido de Oliveira Netto ◽

Gabrielle Pfutzenreuter ◽

Julio Cesar Bassan ◽

...

Keyword(s):

Diagnostic Test ◽

American Football ◽

Control Group ◽

P Value ◽

Genetic Profile ◽

Chi Square ◽

Level Of Evidence ◽

Genotypic Distribution ◽

Significant Difference ◽

Chi Square Test

ABSTRACT Introduction Physical performance depends on a variety of biological and mechanical properties. These different phenotypes are related through the complex interaction between the environment and the individual genetic profile. The hypothesis is that there is a hereditary component that interferes in physical fitness. ACE stands out among the genes that may influence this response. Objectives The objective of this study is to analyze the polymorphism of the ACE gene in American football athletes. Methods: At the end of the study, the sample was composed of 45 male athletes and 72 non-athletes. DNA was extracted from the jugal mucosa. ACE polymorphisms were genotyped through polymerase chain reaction and analyzed using the electrophoresis process. To compare the frequency of genotypes between athletes and the control group, we used the Chi-square test. The association between the frequencies of alleles was verified through the 2X2 contingency tables analyzed using the Chi-square test with Yates correction. The type of study was diagnostic - Investigation of a diagnostic test, level of evidence II. A p-value of ≤0.05 was considered statistically significant for all the analyses. Results The results showed a greater frequency of the D allele in American football athletes when compared with non-athletes, and a significant difference in the genotypic distribution of the athletes being composed of a higher number of the DD genotype as compared to the control group. Conclusion The study provides evidence of the allelic and genotypic influence of ACE polymorphism in amateur American football players in Brazil. Level of evidence II; Investigation of a diagnostic test.

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Discrimination experienced by landed immigrants in Canada

10.32920/ryerson.14639880.v1 ◽

2021 ◽

Author(s):

Parveen Parveen

Keyword(s):

Regression Analysis ◽

Household Income ◽

Older Persons ◽

General Social Survey ◽

Demographic Characteristics ◽

Social Survey ◽

Visible Minorities ◽

Significant Difference ◽

Language Region ◽

Race Ethnicity

Immigrants land in Canada with great hopes and multiple dreams, but the General Social Survey 2009 shows that one-fifth of them face discrimination in various situations once they have arrived. Ethnicity, race, language, and religion are the major grounds of discrimination. In this paper, the experiences of discrimination of landed immigrants are compared with those of non-immigrants. A logistic regression analysis is used on GSS data to predict the probability of facing discrimination based on the socio-economic and demographic characteristics of a person. Separate models are prepared for landed immigrants and non-immigrants. Results show that immigrants are much more likely to face discrimination than non-immigrants. Visible minorities and younger persons face higher levels of discrimination compared to non-visible minorities and older persons. Irrespective of their gender, household income, language, region of domicile, and number of evening activities, landed immigrants have similar chances of facing discrimination; whereas, for non-immigrants, these characteristics make a significant difference in their experiences of discrimination. Key Words: Discrimination, immigrant, race, ethnicity, and human rights.

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Discrimination experienced by landed immigrants in Canada

10.32920/ryerson.14639880 ◽

2021 ◽

Author(s):

Parveen Parveen

Keyword(s):

Regression Analysis ◽

Household Income ◽

Older Persons ◽

General Social Survey ◽

Demographic Characteristics ◽

Social Survey ◽

Visible Minorities ◽

Significant Difference ◽

Language Region ◽

Race Ethnicity

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Surveillance ultrasonography for conservative treatment of femoral shaft fractures in young children

Journal of Orthopaedic Surgery and Research ◽

10.1186/s13018-020-02149-9 ◽

2020 ◽

Vol 15 (1) ◽

Author(s):

Hui Gao ◽

Zhaoxia Wang ◽

Yuxi Su

Keyword(s):

Conservative Treatment ◽

Young Children ◽

Femoral Shaft ◽

Preschool Age ◽

Radiographic Evaluation ◽

Level Of Evidence ◽

Femur Fractures ◽

First Choice ◽

Significant Difference ◽

Skin Traction

Abstract Background The treatment for femoral shaft fracture (FSF) depends on the age of the patient. While the Pavlik harness is the first choice for patients under 6 months of age, spica casting is preferred for patients over 6 months and under preschool age. Minimally-invasive surgery using elastic stable intramedullary nails is also used in some cases. Skin traction is another treatment choice for some patients who are not candidates for the above methods. This study aimed to evaluate the feasibility of surveillance ultrasonography (US) for the conservative treatment of FSFs in young children. Materials and methods This retrospective study included 92 children who were diagnosed with FSF in our hospital from April 2017 to May 2019. After applying the inclusion and exclusion criteria, they were divided into US surveillance (A) and control (B) groups. All patients received conservative treatment by skin traction. For group A, US was used to assess the femur fractures and adjust its reduction on days 1, 3, 5, 7, 10, and 14 until the fracture stabilized. For group B, the fractures were checked by radiographs on days 1, 3, 5, 7, 10, and 14 until the callus appeared. The FSF angle was measured using anteroposterior and lateral radiographs. Results All patients were followed up for 18 months. The radiographic evaluation of both groups at the final follow-up showed a significant difference in the FSF angle. The radiograph times and accumulated radiation also showed significant differences between the two groups. However, there was no significant difference in the incidence of complications. Conclusions For FSF closed reduction, surveillance US is a better option compared to radiographs in children treated by skin traction. This approach can significantly decrease exposure to X-ray radiation and improve the reduction. Level of evidence III

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An Analysis of Sports Specialization in NCAA Division I Collegiate Athletics

Orthopaedic Journal of Sports Medicine ◽

10.1177/2325967118821179 ◽

2019 ◽

Vol 7 (1) ◽

pp. 232596711882117 ◽

Cited By ~ 9

Author(s):

Hasani W. Swindell ◽

Melanie L. Marcille ◽

David P. Trofa ◽

Franklin E. Paulino ◽

Natasha N. Desai ◽

...

Keyword(s):

Ncaa Division I ◽

Elite Athletes ◽

Youth Sports ◽

Team Sports ◽

Division I ◽

P Value ◽

Level Of Evidence ◽

Cross Sectional ◽

Significant Difference ◽

Individual Sports

Background: Youth sports specialization has become more prevalent despite consequences such as increased injury rates and burnout. Young athletes, coaches, and parents continue to have misconceptions about the necessity of sports specialization, giving athletes the encouragement to focus on a single sport at a younger age. Purpose: To characterize the motivations for specialization and determine when elite athletes in various individual and team sports made the decision to specialize. Study Design: Cross-sectional study; Level of evidence, 3. Methods: A Likert-style survey was developed and distributed to athletes from two National Collegiate Athletic Association (NCAA) Division I institutions. The survey’s Flesch-Kincaid grade level was 6.3. Statistical analysis was performed via the Student t test, where a P value less than .05 was considered significant. Results: A total of 303 athletes with a mean ± SD age of 19.9 ± 1.52 years across 19 sports were surveyed; 94.7% of specialized athletes had previously played another organized sport prior to college, and 45% of athletes had played multiple sports up to age 16 years. The mean age of specialization was 14.9 years, with a significant difference between athletes competing in team (15.5 years) and individual (14.0 years) sports ( P = .008). Males in individual sports specialized earlier than those in team sports ( P ≤ .001). Nearly one-fifth (17.4%) of athletes reported specializing at age 12 years or earlier. Personal interest, skill level, time constraints, and potential scholarships were the most important reasons for specialization overall. For individual sports, the motivations for specialization were similar, but collegiate ( P < .001) or professional ( P < .001) ambitions were significantly larger contributing factors. Conclusion: Early sports specialization is uncommon among NCAA Division I athletes for most team sports, whereas individual sports tend to have athletes who specialize earlier and are more motivated by professional and collegiate goals. This study characterized the timing of specialization among elite athletes, providing a basis for understanding the motivations behind youth sports specialization. Physicians should be prepared to discuss the misconception that early sports specialization is necessary or common among most team-focused collegiate-level athletes. Knowing the motivations for sports specialization will guide clinicians in their discussions with youth athletes.

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Effect of Household Income on Short-Term Outcomes Following Cerebellopontine Angle Tumor Resection

Journal of Neurological Surgery Part B Skull Base ◽

10.1055/s-0040-1722664 ◽

2021 ◽

Author(s):

Vincent Huang ◽

Stephen P. Miranda ◽

Ryan Dimentberg ◽

Kaitlyn Shultz ◽

Scott D. McClintock ◽

...

Keyword(s):

Regression Analysis ◽

Household Income ◽

Cerebellopontine Angle ◽

Univariate Analysis ◽

Tumor Resection ◽

Index Admission ◽

P Value ◽

Short Term ◽

Significant Difference ◽

The Impact

Abstract Objectives The objective of this study is to elucidate the impact of income on short-term outcomes in a cerebellopontine angle (CPA) tumor resection population. Design This is a retrospective regression analysis. Setting This study was done at a single, multihospital, urban academic medical center. Participants Over 6 years (from June 7, 2013, to April 24, 2019), 277 consecutive CPA tumor cases were reviewed. Main Outcome Measures Outcomes studied included readmission, emergency department evaluation, unplanned return to surgery, return to surgery after index admission, and mortality. Univariate analysis was conducted among the entire population with significance set at a p-value <0.05. The population was divided into quartiles based on median household income and univariate analysis conducted between the lowest (quartile 1 [Q1]) and highest (quartile 4 [Q4]) socioeconomic quartiles, with significance set at a p-value <0.05. Stepwise regression was conducted to determine the correlations among study variables and to identify confounding factors. Results Regression analysis of 273 patients demonstrated decreased rates of unplanned reoperation (p = 0.015) and reoperation after index admission (p = 0.035) at 30 days with higher standardized income. Logistic regression between the lowest (Q1) and highest (Q4) socioeconomic quartiles demonstrated decreased unplanned reoperation (p = 0.045) and decreasing but not significant reoperation after index admission (p = 0.15) for Q4 patients. No significant difference was observed for other metrics of morbidity and mortality. Conclusion Higher socioeconomic status is associated with decreased risk of unplanned reoperation following CPA tumor resection.

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