Undersizing the Exeter stem in hip hemiarthroplasty increases the risk of periprosthetic fracture

2019 ◽  
Vol 30 (4) ◽  
pp. 469-473
Author(s):  
Lars Korsnes ◽  
Andreas Gottvall ◽  
Christian Buttazzoni ◽  
Michael Mints
Keyword(s):  
Femoral Component ◽  
Area Under Curve ◽  
Size Difference ◽  
Optimal Cutoff ◽  
Hip Hemiarthroplasty ◽  
Stem Size ◽  
Median Size ◽  
Optimal Cutoff Point ◽  
The Difference ◽  
Post Hoc

Introduction: Whether under- or oversizing of the femoral component of cemented hip hemiarthroplasties impacts the risk of periprosthetic fractures (PPF) has only been examined experimentally. This study was carried out to add more knowledge about the risks of PPF in cemented polished tapered hemiarthroplasties. Methods: 20 patients with PPF following hip hemiarthroplasty with cemented Exeter V40 stems were compared to 50 controls who never suffered PPF having received the same type of Exeter hemiprosthesis for the same indication. The difference between stem size and post-hoc radiographic ideal templated size was investigated as a predictor of PPF. Results: Cases had a median size difference to post-hoc templating of –2, while controls had a median size difference of –1 ( p = 0.09). An ROC curve constructed to find an optimal cutoff point in size difference between cases and controls arrived at an area under curve of 63%, with –1.5 as the cutoff. Patients with size differences exceeding –1.5 had a statistically significant increased PPF risk (odds ratio = 3.8, 95% confidence interval, 1.1–13.3, p < 0.05). This group covered 55% of all cases. Conclusion: An implanted femoral component that is 2 or more sizes smaller than the template that is shown to be appropriate will increase the risk of PPF in Exeter hip hemiarthroplasties.

scholarly journals Morphological consistency of bilateral hip joints in adults based on the X-ray and CT data

2021 ◽  
Author(s):  
Ran Zhao ◽  
Hong Cai ◽  
Hua Tian ◽  
Ke Zhang
Keyword(s):  
Hip Joint ◽  
Morphological Difference ◽  
Medullary Cavity ◽  
Size Difference ◽  
Single Plane ◽  
X Ray ◽  
Stem Size ◽  
The Difference ◽  
Ct Data ◽  
Anatomical Parameters

Abstract Purpose The application of the anatomical parameters of the contralateral hip joint to guide the preoperative template of the affected side relies on the bilateral hip symmetry. We investigated the bilateral hip symmetry and range of anatomical variations by measurement and comparison of bilateral hip anatomical parameters. Methods This study included 224 patients (448 hips) who were diagnosed with osteoarthritis (OA) and avascular necrosis (AVN) of the femur head, and underwent bilateral primary total hip arthroplasty (THA) in our hospital from January 2012 to August 2020. Imaging data included 224 patients X-ray and 30 CT data at the end of the cohort. Anatomical parameters, including the acetabular abduction angle and trochanteric height, were measured using the Noble method. Postoperative measurements included stem size, difference of leg length and offset. Results Except for the isthmus width, there were no significant differences in the anatomical morphology of the hip joint. Among the demographic factors, there was a correlation between body weight and NSA. Among various anatomical parameters, a correlation was present between medullary cavity widths of T + 20, T, and T − 20. The difference in the use of stem size is not due to the morphological difference of bilateral medullary cavity, but due to the different of 1- or 2-stage surgery. Conclusion Bilateral symmetry was present among the patients with normal morphology of the hip medullary cavity, theoretically confirming the feasibility of structural reconstruction of the hip joint using the hip joint on the uninjured side. Additionally, the difference in the morphology of the hip medullary cavity is not present in a single plane but is synergistically affected by multiple adjacent planes.

The digiti quinti sign in hemiplegic migraine

Cephalalgia ◽  
2010 ◽  
Vol 31 (1) ◽  
pp. 13-17 ◽  
Author(s):  
Maurice B Vincent ◽  
Fernanda ML Carvalho-e-Silva ◽  
Ronir R Luiz
Keyword(s):  
Sensitivity And Specificity ◽  
Migraine Without Aura ◽  
Clinical Indication ◽  
Motor Deficit ◽  
Optimal Cutoff ◽  
Hemiplegic Migraine ◽  
Optimal Cutoff Point ◽  
The Difference ◽  
The Right ◽  
Symptomatic Side

The digiti quinti sign (DQS), described originally as a clinical indication of subtle motor deficit, consists of a relatively greater abduction of the fifth finger on the affected side when both arms are extended forwards. This sign was previously observed interictally in three consecutive hemiplegic migraine (HM) patients. Patients and methods: To verify whether the DQS specifically discriminates HM from non-hemiplegic migraine (nHM), the angle between the fourth and fifth fingers (ANG) was measured interictally in 10 HM patients, 44 migraine with aura and migraine without aura patients, and 45 healthy controls. Results: The ANG was significantly wider at the symptomatic side in HM as compared with nHM and controls. The differences between the symptomatic and non-symptomatic (for HM) or between the right and left sides (absolute values for nHM and controls) were, respectively, 10.10° ± 9.58°, 4.15° ± 3.95° and 5.37° ± 4.74° ( p = .007). The optimal cutoff point for ANG was 15° at the symptomatic side (sensitivity and specificity of 80.0% and 72.2%, respectively), 10.5° at the non-symptomatic side (sensitivity and specificity of 60.0% and 52.3%), and 3° for the difference between sides (sensitivity and specificity of 90.0% and 79.5%). Conclusion: Data show that the DQS discriminates HM from nHM and controls.

scholarly journals End-Tidal Carbon Dioxide Monitoring for Spontaneous Pneumothorax

2021 ◽  
Vol 2021 ◽  
pp. 1-6
Author(s):  
Gyeong Min Lee ◽  
Yong Won Kim ◽  
Sanghun Lee ◽  
Han Ho Do ◽  
Jun Seok Seo ◽  
...  
Keyword(s):  
Carbon Dioxide ◽  
Spontaneous Pneumothorax ◽  
Area Under Curve ◽  
Clinical Course ◽  
Treatment Strategies ◽  
Optimal Cutoff ◽  
End Tidal Carbon Dioxide ◽  
Carbon Dioxide Monitoring ◽  
The Difference ◽  
End Tidal

Background. Spontaneous pneumothorax should be classified as primary spontaneous pneumothorax (PSP) or secondary spontaneous pneumothorax (SSP) because treatment strategies may differ depending on underlying lung conditions and clinical course. The pulmonary dysfunction can lead to changes in end-tidal carbon dioxide (ETCO2). The aim of this study was to investigate the difference in ETCO2 between PSP and SSP. Methods. This retrospective observational study included adult patients diagnosed with spontaneous pneumothorax in the emergency room from April 2019 to September 2020. We divided patients into PSP and SSP groups and compared ETCO2 variables between the two groups. Results. There were 33 (66%) patients in the PSP group and 17 (34%) patients in the SSP group. Initial ETCO2 was lower in the SSP group than in the PSP group (30 (23–33) vs. 35 (33–38) mmHg, p = 0.002 ). Multivariate analysis revealed that respiratory gas associated with SSP was initial ETCO2 (OR: 0.824; 95% CI: 0.697–0.974, p = 0.023 ). The optimal cutoff for initial ETCO2 to detection of SSP was 32 mmHg (area under curve, 0.754), with 76.5% sensitivity and 72.7% specificity. Conclusion. ETCO2 monitoring is a reliable noninvasive indicator of differentiating between PSP and SSP. Initial ETCO2 lower than 32 mmHg is a predictor of SSP.

High disease activity is associated with higher blood pressure in recent onset rheumatoid arthritis patients, post-hoc analyses of IMPROVED study

2021 ◽  
Vol 28 (Supplement_1) ◽  
Author(s):  
M Gegenava ◽  
SA Bergstra ◽  
H Maassen ◽  
CF Allaart
Keyword(s):  
Rheumatoid Arthritis ◽  
Blood Pressure ◽  
Disease Activity ◽  
Classification Criteria ◽  
Recent Onset ◽  
American College Of Rheumatology ◽  
Cardiovascular Morbidity And Mortality ◽  
The Difference ◽  
Post Hoc ◽  
Acpa Status

Abstract Funding Acknowledgements Type of funding sources: None. Background Rheumatoid arthritis (RA) is a chronic autoimmune disease with a high prevalence of cardiovascular morbidity and mortality. Purpose: purpose of our project was to investigate the association between disease activity and systolic and diastolic blood pressure (SBP, DBP) in patients with recent-onset rheumatoid arthritis (RA 2010 criteria) or undifferentiated arthritis (UA) who were treated to target disease activity score (DAS)&lt;1.6 in the IMPROVED study. Methods: The associations between disease activity and SBP/DBP were tested for 610 patients (364 RA, 246 UA), cross-sectionally and over time. GEE analyses were performed with both SBP and DBP as outcome measures and disease activity categories (DAS&lt;1.6;&gt;1.6 but ≤2.4; &gt;2.4), CRP level, treatment arms or the number of visits on a certain drug as potential predictors in separate analyses. Separate analyses tested potential contributions of gender, anti-cyclic citrullinated peptide antibodies (ACPA) status, and fulfilling the 2010 ACR/EULAR (American college of rheumatology/ European league against rheumatism) classification criteria. In addition association of BP with various levels of disease activity was tested with T-test. Results: At the baseline mean (SD) SBP was 133 (20) and DBP mean (SD) was 80 (10).  SBP &gt; 140mm Hg was observed in 40% of patients and DBP &gt; 90 mm Hg  in 21% of patients. SBP and DBP statistically significantly decreased during 5 years follow up (mainly during year 1), but the difference in mm Hg was small. Estimates from GEE analysis showed that patients with high DAS &gt;2.4 (HDAS) had a statistically significantly higher SBP (average 3 mm Hg higher, 95% CI 1.7; 4.2, p &lt; 0.01), than the patients in with DAS ≤2.4. ANOVA analyses showed a statistically significant association between SBP and DAS. In addition, post hoc analyses showed that patients with HDAS had a statistically significantly higher  SBP (mean (SD) 132 (19) than the patients with DAS &lt; 1.6 (remission) (mean (SD) 129 (20), p &lt; 0.01), and patients in LDAS but DAS≥1.6 had a statistically significantly higher SBP (mean (SD) 131 (19) than the patients in remission (mean (SD)  129 (20), p = 0.02) (Figure 1), whereas no association was found between DAS category and DBP. Gender, ACPA status or fulfilling the 2010 classification criteria did not influence the relation between DAS and blood pressure. Conclusions: In patients with RA or UA, a higher DAS is associated with higher blood pressure, but the clinical impact is unclear. Abstract Figure 1

scholarly journals Characteristics of anteroposterior curvatures of the spine in soccer and futsal players

2017 ◽  
Vol 18 (4) ◽  
Author(s):  
Krystyna Chromik ◽  
Anna Burdukiewicz ◽  
Jadwiga Pietraszewska ◽  
Aleksandra Stachoń ◽  
Paweł Wolański ◽  
...  
Keyword(s):  
College Students ◽  
Statistical Analysis ◽  
Injury Prevention ◽  
Analysis Of Variance ◽  
Statistical Significance ◽  
Body Posture ◽  
Soccer Players ◽  
Prevention Training ◽  
The Difference ◽  
Post Hoc

AbstractPurpose. The aim of the study was to determine differences in anteroposterior spine curvatures between futsal players, soccer players, and non-training students. The results may contribute to the development of present-day knowledge of posturometry, and its implementation in training can help reduce the risk of body posture disorders in athletes. Methods. The examined group consisted of 48 athletes and 38 non-training college students. Body posture parameters were measured with the use of Posturometr-S. The normality of distribution was checked with the Shapiro-Wilk test, and the differences between the groups were measured with ANOVA and the Bonferroni post-hoc test. The level of statistical significance was set at p < 0.05. Results. The analysis of angle values revealed the widest and most similar measurements in the group of futsal players and soccer players. The analysis of variance proved statistically significant differences between the soccer players and futsal players (p = 0.003). The difference between the soccer players and non-training students was statistically significant. The highest γ angular value was measured in non-training students, followed by futsal players and soccer players. The statistical analysis revealed significant differences between the non-training students and futsal players, as well as non-training students and soccer players (p < 0.001). Conclusions. A complex assessment of athletes’ body posture is crucial in injury prevention. Training overloads may often lead to disorders of the organ of locomotion and affect the correct body posture in athletes. This, in turn, may result in pains and injuries.

scholarly journals Serum Interleukin-2 (IL-2) Levels in Untreated and Treated in Batak Tribe Patients with Schizophrenia

2021 ◽  
Vol 4 (1) ◽  
pp. 1449-1460
Author(s):  
Julius Martin Siagian ◽  
Elmeida Effendy ◽  
Mustafa M. Amin
Keyword(s):  
General Hospital ◽  
Pearson Correlation ◽  
Interleukin 2 ◽  
Cross Sectional ◽  
Welch Test ◽  
Pearson Correlation Test ◽  
Healthy Control ◽  
The Difference ◽  
Post Hoc ◽  
One Way Anova

To find out the difference of serum IL-2 levels between untreated and treated in the Batak tribe patients with schizophrenia and healthy control and also to find out the association between serum IL-2 levels with PANSS score in the Batak tribe patients with schizophrenia. This study was cross-sectional approach using a one-way ANOVA welch test and to find a correlation between serum IL-2 levels with PANSS score in the Batak tribe patients with schizophrenia which is conducted in Prof. Dr. M. Ildrem Psychiatric Hospital Medan and Dr. Pirngadi General Hospital Medan from September 2019-November 2019. Subjects of untreated were 55 subjects and treated in the Batak tribe patients with schizophrenia were 55 subjects and healthy control were 55 subjects. There were significant differences between these three groups using post hoc Games-Howell test on the value of p<0.001 and also been found there was a significant correlation between serum IL-2 levels with PANSS score in the Batak tribe patients with schizophrenia using the Pearson correlation test (r=0.599, p=0.001 and r=0.501, p=0.001). It was founded that there were significant differences between serum IL-2 levels in three groups and also founded there was a significant correlation between serum IL-2 levels with PANSS score in the Batak tribe patients with schizophrenia. 

scholarly journals Impact of Portfolio Strategies on Portfolio Performance and Risk

2018 ◽  
Vol 10 (1) ◽  
pp. 73
Author(s):  
Zunera Shaukat ◽  
Ahmad Shahzad
Keyword(s):  
Asset Allocation ◽  
Stock Prices ◽  
Sharpe Ratio ◽  
Portfolio Performance ◽  
Dynamic Asset Allocation ◽  
Portfolio Strategies ◽  
Tactical Asset Allocation ◽  
The Difference ◽  
Post Hoc ◽  
The Relationship

The Portfolio strategies are the effective investment tools pertaining to active and passive investment approaches. This signifies the investor’s inclination of buying and selling the risky and risk-free assets. The research includes four strategies namely buy and hold strategy, dynamic asset allocation, strategic asset allocation and tactical asset allocation along with their dimensions. Strategies based hypothetical portfolios are generated on the basis of 14 years’ stock prices (2005-2017). The annually and monthly risk-adjusted return ratios; Sharpe ratio, Treynor’s measure, CAPM and Jenson Alpha are calculated individually. Simulated annualized portfolios generate significant result with Sharpe and treynor measure. Alpha return is generated with buy and hold if based on growth in stock prices. For empirical result, One-way analysis of variance (ANOVA) is used for studying the relationship between the strategies. Post hoc Tukey’s test is applied to find the difference between the strategies. The ANOVA and Tukey’s post hoc test for monthly portfolios gives significant results with three measure Sharpe ratio, CAPM and Jenson Alpha. No empirical significant result is measured on the basis of treynor measure.

scholarly journals Perception of Dentofacial Aesthetics in School Children and Their Parents

2020 ◽  
Author(s):  
Alisa Tiro ◽  
Enita Nakas ◽  
Amra Arslanagic ◽  
Nina Markovic ◽  
Vildana Dzemidzic
Keyword(s):  
Age Groups ◽  
P Value ◽  
Older Children ◽  
School Students ◽  
Children And Parents ◽  
Chi Squared ◽  
Dental Aesthetics ◽  
The Difference ◽  
Post Hoc ◽  
The City

Abstract Objective The aim of this research was to examine the attitudes and perceptions of dentofacial aesthetics among different age groups. Materials and Methods The sample consisted of elementary-school students from the city of Sarajevo, Bosnia and Herzegovina, and their parents. This study included 314 subjects: 157 children and 157 parents. The children’s group consisted of 85 (54.14%) males and 72 (45.85%) females, aged 9 to 15 years. Statistical Analysis Descriptive statistics were used to determine frequency distribution and percentages for all variables. A chi-squared (x 2) test was used to determine the association between variables and a p-value < 0.05 was considered significant for all the differences and associations. Results For the dentofacial appearance with no teeth irregularity or with severe teeth irregularity, an analysis of variance (ANOVA) (post-hoc tests—Tukey’s HSD) indicated that the difference is not statistically significant (p = 0.06) relative to rank matching between all three subject groups.For dentofacial appearance with mild teeth irregularity, an ANOVA (post-hoc tests—Tukey’s HSD) showed statistical difference (p = 0.07) between the teenage group of subjects relative to pre-teenage group of subjects and adult group of subjects. Conclusion Attitudes about desirable and acceptable dental aesthetics differ in younger children compared with older children and parents. Ten years old children find good function with poor aesthetics more pleasing, while 14 years old children find aesthetics with bad function as more pleasing.

Peak Flow Rate During Induced Cough: A Predictor of Successful Decannulation of a Tracheotomy Tube in Neurosurgical Patients

2010 ◽  
Vol 19 (3) ◽  
pp. 278-284 ◽  
Author(s):  
Linda Y. Y. Chan ◽  
Alice Y. M. Jones ◽  
Raymond C. K. Chung ◽  
K. N. Hung
Keyword(s):  
Flow Rate ◽  
Operating Characteristic ◽  
Peak Flow ◽  
Characteristic Curve ◽  
Peak Flow Rate ◽  
Tracheotomy Tube ◽  
Optimal Cutoff ◽  
Neurosurgical Patients ◽  
Optimal Cutoff Point ◽  
The Relationship

Background An accurate predictor of successful decannulation in neurosurgical patients that indicates the best time for tracheotomy decannulation would minimize the risks of continued cannulation and unsuccessful decannulation. Objective To determine whether the peak flow rate during induced cough is an appropriate predictor of successful decannulation. Methods A total of 32 neurosurgical patients with a tracheotomy were enrolled. The highest peak expiratory flow rate during 3 induced coughs, the total volume of tracheal secretions collected in 6 hours, and scores on the Glasgow Coma Scale were recorded. Logistic regression analysis was applied to determine the relationship between these variables and successful decannulation (reintubation not required within 72 hours). Results Decannulation was attempted in 23 of 32 patients. The remaining 9 patients were considered clinically inappropriate for the procedure. Of the 23 patients decannulated, 2 required reinsertion of the tracheotomy tube. Analysis revealed that peak flow rate during induced cough (odds ratio, 1.12; 95% confidence interval, 1.02–1.23) was independently associated with successful decannulation (accuracy, 75%; sensitivity, 85.7%; specificity, 54.5%). The receiver operating characteristic curve indicated an optimal cutoff point of 29 L/min. Conclusion Measurement of peak flow rate during induced cough is a simple and reproducible intervention that improves predictability of successful decannulation in patients with tracheotomy.

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