Trochlear dysplasia influences patellotrochlear index when measuring patella alta

Objectives: Patella alta is a risk factor for patellar instability and its recurrence after treatment. The patellotrochlear index (PTI) is a measurement used to quantify patella alta, describing patellar engagement in the trochlea through an index of trochlear overlap with patellar articular surface based on sagittal imaging. Values less than 20% have been reported to indicate patella alta, yet this measurement has primarily been described in normal knees. Trochlear dysplasia is also a common risk factor in patellar instability and can affect the length of the trochlea. Therefore the purpose of this study was to compare PTI measurements in knees with and without trochlear dysplasia, and to describe its relationship with trochlear length. Methods: Knees with trochlear dysplasia (defined by trochlear depth<4mm) based on CT imaging were identified from a series of knees with symptomatic patellar instability and compared to age- and gender matched asymptomatic controls. Measurements of patellar height including PTI and Caton Deschamps Index (CDI) were performed, as well as additional measurements of trochlear dysplasia including lateral trochlear inclination [LTI] and sulcus angle [SA]. Trochlear length was quantified using a previously described method of trochlear center-edge angle (TCEA) measurement, an angle between the posterior femoral cortical line with its intersection with Blumensaat’s line to the most proximal margin of the trochlea, with a smaller angle indicating more proximal extension of the trochlea. TCEA was measured at the central, medial, and lateral trochlea. Measurements were compared between dysplastic and control groups using t-test. Linear and multivariate regression analyses were performed to assess the relationship between PTI and measurements of trochlear dysplasia. Results: 21 knees with trochlear dysplasia (13 female and 8 male) were included in this study, and were compared with 21 age- and gender-matched controls. In the dysplastic group, trochlear depth (TD) was 0.7+/-2.4mm vs 6.8+/-2.5mm (p<0.001) in the control group, SA was 154.2+/-11.5 degrees vs 134.0+/-8.3 degrees (p<0.001), and LTI was 12.1+/-6.2 vs 23.7+/-4.4 degrees (p<0.001) . Despite CDI being greater in the symptomatic group (1.19+/-0.23 vs 1.06+/-0.19, p=0.053), PTI was greater (with more overlap) in the symptomatic group (34.92+/-15.23% vs 25.43+/-21.55%, p=0.076). In the symptomatic group, the trochlear groove extended more proximally at the central (TCEA 58.4 degrees vs 68.6 degrees, p<0.001) and medial aspects (68.9 degrees vs 77.9 degrees, p<0.001). In dysplastic knees, PTI demonstrated a weak negative correlation with TCEA (R=-0.40) and with LTI (R=-0.45). Conclusion: In this study, knees with trochlear dysplasia had a PTI of 35% vs 25% in the control group, indicating greater patellar engagement despite having greater measurements of patella alta based on CDI (1.19 vs 1.06). PTI correlated with increased proximal extension of the trochlea which may account for the greater patellofemoral overlap. As abnormal trochlear length can associated with supratrochlear spurs, greater values on PTI may not necessarily indicate functional patellofemoral engagement. Further studies are needed to identify the functional relationship between trochlear length and patella alta.

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Abstract 3503: Ovarian Cancer Increases the Risk of Stroke, but Not in Patients with Hypertension, Diabetes or Both

Stroke ◽

10.1161/str.43.suppl_1.a3503 ◽

2012 ◽

Vol 43 (suppl_1) ◽

Author(s):

Tsang-Shan Chen

Keyword(s):

Ovarian Cancer ◽

Risk Factor ◽

Incidence Rate ◽

Stroke Risk ◽

Case Reports ◽

Control Group ◽

Apparent Paradox ◽

Stroke Risk Factor ◽

Age And Gender ◽

And Gender

Background and Purpose: Cancer and stroke are the first and third leading cause of death in Taiwan respectively. Cancer has been considered to be a stroke risk factor. Ovarian cancer as a cause of stroke has appeared in the literature as case reports featuring increase in systemic thromboembolic tendency, frequently associated with non-bacterial endocarditis. To the best of our knowledge, no systemic assessment of ovarian cancer as a stroke risk factor has been made. Based on the Taiwan National Health Insurance claim files covering 1997 - 2008, we explored ovarian cancer as a stroke risk factor. Methods: There were a total of 8,728 patients with diagnosis of ovarian cancer from 1997 to 2007. A cohort of 34,912 age- and gender-matched patients without cancer served as the control group. Both groups were followed until the end of 2008. The ovarian cancer and control cohorts were further divided into 2 subgroups with and without key stroke risk factors (hypertension, diabetes, or both). Cox proportional hazard regression analysis was used to estimate the stroke risk in patients with ovarian cancer to derive hazard ratios (HRs) and 95% confidence intervals (CIs) Results: In the ovarian cancer cohort without hypertension or diabetes, the incidence rate was 4.89 per 1000 person-years in comparison with 4.70 in the control group without comorbidity. The hazard ratio (HR) is 1.44 (95% CI 1.22-1.77). For the ovarian cancer cohort with hypertension, diabetes or both, the incidence rate of stroke was 12.05 per 1000 person-years as compared to 30.67 in the control cohort with hypertension, diabetes or both. The HR is 0.44 (95% CI 0.29-0.68). Conclusion: Ovarian cancer increased the risk of stroke by 44% in patients without hypertension, diabetes or both in comparison with the age- and gender-matched control without the same comorbidity. However, patients with ovarian cancer who had hypertension, diabetes or both had signnificantly lower stroke risk than the control group with the same comorbidity. The mechanism for the apparent paradox associated with comorbidity (hypertension, diabetes or both) known to increase the stroke risk in patients with ovarian cancer remains to be determined.

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Dental and periodontal disease in patients with inflammatory bowel disease

Clinical Oral Investigations ◽

10.1007/s00784-021-03835-6 ◽

2021 ◽

Author(s):

Christopher X. W. Tan ◽

Henk S. Brand ◽

Bilgin Kalender ◽

Nanne K. H. De Boer ◽

Tymour Forouzanfar ◽

...

Keyword(s):

Inflammatory Bowel Disease ◽

Periodontal Disease ◽

Bowel Disease ◽

Health Problems ◽

Control Group ◽

Age And Gender ◽

Preventive Dental Care ◽

Dmft Index ◽

Inflammatory Bowel ◽

And Gender

Abstract Objectives Although bowel symptoms are often predominant, inflammatory bowel disease (IBD) patients can have several oral manifestations. The aim of this study was to investigate the prevalence of dental caries and periodontal disease in patients with Crohn’s disease (CD) and ulcerative colitis (UC) compared to an age and gender-matched control group of patients without IBD. Material and methods The DMFT (Decayed, Missing, Filled Teeth) scores and the DPSI (Dutch Periodontal Screening Index) of 229 IBD patients were retrieved from the electronic health record patient database axiUm at the Academic Centre for Dentistry Amsterdam (ACTA) and were compared to the DMFT scores and DPSI from age and gender-matched non-IBD patients from the same database. Results The total DMFT index was significantly higher in the IBD group compared to the control group. When CD and UC were analyzed separately, a statistically significant increased DMFT index was observed in CD patients but not in UC patients. The DPSI did not differ significantly between the IBD and non-IBD groups for each of the sextants. However, in every sextant, IBD patients were more frequently edentulous compared to the control patients. Conclusion CD patients have significantly more dental health problems compared to a control group. Periodontal disease did not differ significantly between IBD and non-IBD groups as determined by the DPSI. Clinical relevance It is important that IBD patients and physicians are instructed about the correlation between their disease and oral health problems. Strict oral hygiene and preventive dental care such as more frequent checkups should be emphasized by dental clinicians.

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A Study of Wideband Energy Reflectance in Patients with Otosclerosis: Data from a Chinese Population

BioMed Research International ◽

10.1155/2019/2070548 ◽

2019 ◽

Vol 2019 ◽

pp. 1-8 ◽

Cited By ~ 4

Author(s):

Suju Wang ◽

Wenyang Hao ◽

Chunxiao Xu ◽

Daofeng Ni ◽

Zhiqiang Gao ◽

...

Keyword(s):

Resonance Frequency ◽

Racial Differences ◽

Chinese Population ◽

Ambient Pressure ◽

Control Group ◽

Age And Gender ◽

Significant Difference ◽

And Gender ◽

And Control ◽

Peak Pressures

Objective(s). The purpose of this study was to explore the effectiveness of wideband acoustic immittance (WAI) in the diagnosis of otosclerosis by comparing the differences in the energy reflectance (ER) of WAI between patients with otosclerosis and age- and gender-matched normal hearing controls in the Chinese population. Methods. Twenty surgically confirmed otosclerotic ears were included in the otosclerotic group. The ER of WAI at ambient and peak pressures, resonance frequency, and 226-Hz tympanogram were collected prior to surgery using a Titan hearing test platform (Interacoustics A/S, Middelfart, Denmark). All diagnoses of otosclerosis in the tested ear were confirmed by surgery after the measurements. Thirteen normal adults (26 ears) who were age- and gender-matched with the otosclerotic patients were included as the control group. Results. At peak pressure, the ERs of otosclerotic patients were higher than those of the control group for frequencies less than 4,000Hz and were lower for frequencies greater than 4,000Hz. In addition, within the analyzed frequencies, the differences observed at 2,520Hz was statistically significant (p<0.05/16=0.003, Bonferroni corrected). At ambient pressure, the differences observed at 1,260 and 6,350Hz were statistically significant (p<0.05/16=0.003, Bonferroni corrected). Although the differences between the otosclerotic and control groups exhibited similar trends to those in studies implemented in Caucasian populations, the norms in the present study in the control group were different from those in the Caucasian populations, suggesting racial differences in WAI test results. Regarding the middle ear resonance frequency, no significant difference was observed between the two groups (P>0.05). Conclusion. WAI can provide valuable information for the diagnosis of otosclerosis in the Chinese population. Norms and diagnostic criteria corresponding to the patient’s racial group are necessary to improve the efficiency of WAI in the diagnosis of otosclerosis.

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Immature granulocyte and other hematological inflammatory parameters in patients with migraine headache

10.51271/kmj-0025 ◽

2021 ◽

pp. 101-104

Keyword(s):

Complete Blood Count ◽

Control Group ◽

Age And Gender ◽

Neutrophil Lymphocyte Ratio ◽

Lymphocyte Ratio ◽

Inflammatory Parameters ◽

Group Data ◽

Healthy Control ◽

Immature Granulocyte ◽

And Gender

Background: Today, many hypotheses have been proposed in the pathogenesis of migraine. The inflammatory hypothesis is one of them. The immature granulocyte count (IGC) is also an inflammatory parameter which importance has been understood recently. There are no studies evaluating IGC in migraine. The aim of the study to investigate the levels of IGC and other hematological inflammatory parameters in migraine. Material and Method: Materials and Methods: Forty-eight patients diagnosed with migraine who applied to Kastamonu Training and Research Hospital Neurology outpatient clinic between 07.01.2020 and 10.01.2021 were included in the study. 42 people with similar age and gender distribution were included for the control group. Data on laboratory tests, age and gender of patients were obtained from the hospital Laboratory Information System (LIS). CBC parameters of the patients at the first admission and before any treatment, calculated with an automated hematological analyzer (XN-1000-Hematology-analyzer-Sysmex Corporation, Japan) were analyzed. Using Complete Blood Count (CBC) data, neutrophil count (NEUT#), neutrophil percentage (NEUT%), lymphocyte percentage (LYMPH%), and IGC were recorded. Neutrophil lymphocyte ratio (NLR), platelet lymphocyte ratio (PLR), and systemic immune inflammation index (SII) values were calculated with the formula. Results: In our study, NLR and IGC was significantly higher than the healthy control group (p=0.002, p=0.025). PLR was also found to be high, but it was not statistically significant (p=0.063). Conclusion: The significantly higher NLR and IGC levels in migraine patients compared to the healthy controls support the role of inflammation in etiopathogenesis.

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Balance and motor coordination are not fully developed in 7 years old blind children

Arquivos de Neuro-Psiquiatria ◽

10.1590/s0004-282x2004000400016 ◽

2004 ◽

Vol 62 (3a) ◽

pp. 654-657 ◽

Cited By ~ 20

Author(s):

Andréa Sanchez Navarro ◽

Marcia Maiumi Fukujima ◽

Sissy Veloso Fontes ◽

Sandro Luiz de Andrade Matas ◽

Gilmar Fernandes do Prado

Keyword(s):

Visually Impaired ◽

Motor Coordination ◽

Psychomotor Development ◽

Control Group ◽

Age And Gender ◽

Blind Children ◽

Spatial Parameters ◽

And Gender ◽

Impaired Children ◽

Visually Impaired Children

Visually impaired children show difficulties in recognizing their own bodies, objects around then and the spatial parameters that are essential for independent movement. This study analyzes the neuro-psychomotor development of a group of congenitally visually impaired children as compared to children with normal sight. We have evaluated two groups of seven-year-olds by means of neurological evolution examination (NEE). The group studied comprised 20 blind children and the control group comprised 20 children with normal sight, and they were paired up according to age and gender. In some tests, the blind children were guided by touch. The visually impaired children performed worse in tests evaluating balance and appendage coordination compared to normal sighted children (p< 0.001), and this suggests that visual deficiency impairs children's neuro-psychomotor development.

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Multiple Gene Polymorphisms Associated with Exfoliation Syndrome in the Uygur Population

Journal of Ophthalmology ◽

10.1155/2019/9687823 ◽

2019 ◽

Vol 2019 ◽

pp. 1-8 ◽

Cited By ~ 1

Author(s):

Yi-Nu Ma ◽

Ting-Yu Xie ◽

Xue-Yi Chen

Keyword(s):

Protective Factor ◽

Lysyl Oxidase ◽

Direct Sequencing ◽

Control Group ◽

Exfoliation Syndrome ◽

Nucleotide Polymorphisms ◽

Age And Gender ◽

Protective Allele ◽

Significant Difference ◽

And Gender

Background. Our previous data suggested that three single-nucleotide polymorphisms (SNPs), rs1048661, rs3825942, and rs2165241, of the lysyl oxidase-like 1 gene (LOXL1) are significantly associated with exfoliation syndrome (XFS) and exfoliation glaucoma (XFG). The following study investigated other SNPs that potentially effect XFS/XFG. Methods. A total of 216 Uygur patients diagnosed with XFS/XFG, and 297 Uygur volunteers were admitted to the First Affiliated Hospital at Xinjiang Medical University between January 2015 and October 2017. Blood samples were collected by venipuncture. Alleles and genotypes of LOXL1, TBC1D21, ATXN2, APOE, CLU, AFAP1, TXNRD2, CACNA1A, ABCA1, GAS7, and CNTNAP2 were analyzed by direct sequencing. Results. The allele G of rs41435250 of LOXL1 was a risk allele for XFS/XFG (P<0.001), whereas the allele G of rs893818 of LOXL1 was a protective allele for XFS/XFG (P<0.001). After adjusting all data for age and gender, the following results were obtained: the frequency of genotype CC for rs7137828 of ATXN2 was significantly higher in XFS/XFG patients than in controls (P=0.027), while no significance was found with reference to the frequency of genotype TT. The frequency of genotype GG for rs893818 of LOXL1 (P<0.001) and the frequency of genotype AA were both significantly higher in XFS/XFG groups compared to the control group (P<0.001). In addition, the frequency of genotype TT for rs41435250 of LOXL1 was higher in XFS/XFG patients than in controls (P=0.003), while no significant difference was found with reference to the frequency of genotype GG after adjusting for age and gender. In addition, the haplotypes G-A/T-G/G-G for rs41435250 and rs893818 were significantly associated with XFS/G. Conclusions. With reference to LOXL1, the rs41435250 resulted as a risk factor and rs893818 as a protective factor for XFS/XFG in the Uygur populations. Meanwhile, the rs16958445 of TBC1D21 and the rs7137828 of ATXN2 have also shown to be associated with pathogenesis of XFS/XFG.

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RISK FACTORS FOR PATELLAR INSTABILITY USING A QUANTITATIVE ANALYSIS OF TROCHLEAR DYSPLASIA

Orthopaedic Journal of Sports Medicine ◽

10.1177/2325967120s00344 ◽

2020 ◽

Vol 8 (7_suppl6) ◽

pp. 2325967120S0034

Author(s):

Jon Hedgecock ◽

Christopher Cheng ◽

Matthew Solomito ◽

James Pace

Keyword(s):

Risk Factors ◽

Risk Factor ◽

Roc Curve ◽

Patellar Instability ◽

Trochlear Dysplasia ◽

Roc Curves ◽

Patellar Height ◽

Sulcus Angle ◽

Demographic Risk ◽

Demographic Risk Factors

Objectives: Multiple studies have described several anatomic and demographic risk factors of patellar instability (PI). Trochlear dysplasia (TD) has been shown to be a dominant risk factor for patellar instability but most prediction models have used the qualitative Dejour system to evaluate the influence of TD on PI. The lateral trochlear inclincation (LTI) angle is a described quantitative method to evaluate TD and a recent measurement technique has near perfect inter and intra rater reliability. Our hypothesis is that, in combination with other known radiographic and demographic risk factors of PI, that using a quantitative and numeric evaluation for TD, a highly reliable prediction model for PI can be created. Methods: 98 patients in a pediatric and adolescent sports medicine practice were identified with documented PI that had magnetic resonance imaging (MRI) studies available for review. A matched cohort of 100 patients with no history of PI but with MRI’s were identified as a control group. Anatomic risk factors evaluated included the LTI, sulcus angle, lateral condyle index (LCI), lateral patellar inclination angle (LPI), proximal and distal tibial tubercle-trochlear groove distance (pTTTG and dTTTG), Caton-Deschamps ratio (CD ratio), and patellotrochlear index (PTI). Demographic data included age and sex. Receiver operator characteristic (ROC) curves were constructed for each variable to identify which variables were the best predictors of PI (ROC value >0.7). Using the ROC curves with a Youden’s J statistic and setting specificity at 0.9, cutoff values for each variable were created. Each radiographic and demographic variable was analyzed for significance and those that were found to be significant were analyzed. Area under the curve (AUC) was determined for each variable. Two predictive models were created. One was developed from the ROC curve results while the other evaluated all measured variables. The models were designed to produce the best possible fit while trying to limit the total number of predictors. These models were tested on a second cohort of 45 patients with PI and 42 control patients. Results: ROC curve data is in Table 1. Of the two models, the superior model was the model that evaluated all variables, regardless of ROC cutoff value. The model takes on the form of a general logistic regression (Eq 1, Eq 2). Model accuracy on the validation set showed 84% accuracy with 78% sensitivity and 88% specificity. These values are based on a probability of >90%. Patellar height measures had significant AUC’s but were not prime drivers of the final model. Age was not significant in the ROC analysis. Conclusion: This study establishes a highly reliable and predictive model for PI that is driven by various direct (LTI, sulcus angle, LCI) or indirect (dTT-TG, LPI) quantitative measurements of TD. Patellar height did correlate with PI but was not a prime driver of the model which suggests that patella alta is a less common risk factor for PI.

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Systemic Lupus Erythematosus and Peritoneal Dialysis: Outcomes and Infectious Complications

Peritoneal Dialysis International ◽

10.1177/089686080102100206 ◽

2001 ◽

Vol 21 (2) ◽

pp. 143-148 ◽

Cited By ~ 27

Author(s):

Jenq-Wen Huang ◽

Kuan-Yu Hung ◽

Chung-Jen Yen ◽

Kwan-Dun Wu ◽

Tun-Jun Tsai

Keyword(s):

Systemic Lupus Erythematosus ◽

Lupus Erythematosus ◽

Infectious Complications ◽

Control Group ◽

Systemic Lupus ◽

Exit Site ◽

Age And Gender ◽

Exit Site Infection ◽

Technique Survival ◽

And Gender

Objective Systemic lupus erythematosus (SLE) is the most common secondary glomerulonephritis resulting in end-stage renal disease (ESRD) among young adults in Taiwan. Studies of the infectious complications and outcomes among such SLE patients undergoing peritoneal dialysis (PD) are limited. Design A retrospective age- and gender-matched case control study. Setting A university teaching hospital. Patients There were 23 SLE patients with ESRD receiving PD for more than 3 months during the past 15 years. Another 46 age- and gender-matched non-SLE nondiabetic patients receiving PD were selected as the control group in this study. Intervention All patients underwent PD as renal replacement therapy and were regularly followed up at this hospital. Main Outcome Measures Technique survival and incidences of exit-site infection (ESI) and peritonitis in these patients. Results The SLE patients had a lower predialysis serum albumin than the control group (3.16 ± 0.50 g/dL vs 3.52 ± 0.50 g/dL, p < 0.01). The incidences of exit-site infection (ESI) and peritonitis were higher for SLE patients than for control patients ( p < 0.01 and p < 0.001, respectively). Kaplan–Meier survival analysis indicated that SLE patients had shorter time intervals to first infectious complications, and poorer technique survival. Infection was the major cause of dropout and mortality in the SLE patients. The SLE patients had a reduced chance of receiving a renal transplant. The use of steroids by SLE patients was associated with a higher incidence of peritonitis ( p = 0.04), but association with ESI was insignificant. In a Cox regression model, the underlying SLE was the only risk factor for technique failure and time interval to first infectious complication. Conclusion SLE patients undergoing PD are more susceptible to infection than age- and gender-matched non-SLE nondiabetic patients and have poorer technique survival. Systemic lupus erythematosus itself may further compromise the immunity of uremic patients.

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Increased monohexosylceramide levels in the serum of established rheumatoid arthritis patients

Rheumatology ◽

10.1093/rheumatology/kez545 ◽

2019 ◽

Vol 59 (8) ◽

pp. 2085-2089

Author(s):

Gabriel Miltenberger-Miltenyi ◽

Ana Rita Cruz-Machado ◽

Jennifer Saville ◽

Vasco A Conceição ◽

Ângelo Calado ◽

...

Keyword(s):

Rheumatoid Arthritis ◽

Early Arthritis ◽

Classification Criteria ◽

Control Group ◽

Established Rheumatoid Arthritis ◽

Regression Analyses ◽

Lipid Levels ◽

Age And Gender ◽

Patient Groups ◽

And Gender

Abstract Objectives To identify serum sphingolipids that could act as candidate biomarkers in RA. Methods We performed lipidomic analyses in the serum of 82 participants: 19 established RA patients, 18 untreated early RA patients, 13 untreated early arthritis patients not fulfilling the classification criteria for RA, 12 established SpA patients and 20 controls. We compared the lipid levels from the different patient groups with the control group through multiple-regression analyses controlling for age at diagnosis, gender and medication (cDMARDs and corticoids). Results Established RA patients had significantly increased levels of sphingosine, monohexosylceramide and ceramide compared with controls, when controlling for age and gender. Monohexosylceramide levels remained significantly increased when additionally controlling for medication. On the contrary, SpA patients had significantly decreased levels of ceramide, in both analyses. Conclusion We observed a detectable increase in the levels of certain sphingolipids in the serum of established RA patients when compared with controls, in line with previous observations in the synovial fluid. Such findings provide further evidence that sphingolipids may play a key role in the pathophysiology of RA.

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Inflammatory Bowel Disease in Children of Middle Eastern Descent

International Journal of Pediatrics ◽

10.1155/2014/906128 ◽

2014 ◽

Vol 2014 ◽

pp. 1-7 ◽

Cited By ~ 4

Author(s):

Christina Mai Ying Naidoo ◽

Steven T. Leach ◽

Andrew S. Day ◽

Daniel A. Lemberg

Keyword(s):

Inflammatory Bowel Disease ◽

Bowel Disease ◽

Middle Eastern ◽

Control Group ◽

Colonic Disease ◽

Disease Course ◽

Age And Gender ◽

Inflammatory Bowel ◽

And Gender ◽

And Behavior

Increasing rates of inflammatory bowel disease (IBD) are now seen in populations where it was once uncommon. The pattern of IBD in children of Middle Eastern descent in Australia has never been reported. This study aimed to investigate the burden of IBD in children of Middle Eastern descent at the Sydney Children’s Hospital, Randwick (SCHR). The SCHR IBD database was used to identify patients of self-reported Middle Eastern ethnicity diagnosed between 1987 and 2011. Demographic, diagnosis, and management data was collected for all Middle Eastern children and an age and gender matched non-Middle Eastern IBD control group. Twenty-four patients of Middle Eastern descent were identified. Middle Eastern Crohn’s disease patients had higher disease activity at diagnosis, higher use of thiopurines, and less restricted colonic disease than controls. Although there were limitations with this dataset, we estimated a higher prevalence of IBD in Middle Eastern children and they had a different disease phenotype and behavior compared to the control group, with less disease restricted to the colon and likely a more active disease course.

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