scholarly journals Driving After Total Ankle Arthroplasty

2018 ◽  
Vol 3 (3) ◽  
pp. 2473011418S0008
Author(s):  
Elizabeth McDonald ◽  
David Pedowitz ◽  
Rachel Shakked ◽  
Joseph Daniel ◽  
Kristen Nicholson ◽  
...  
Keyword(s):  
Total Ankle Arthroplasty ◽  
Institutional Review Board ◽  
Control Group ◽  
Analog Scale ◽  
Ankle Arthroplasty ◽  
Patient Demographics ◽  
Institutional Review Board Approval ◽  
Institutional Review ◽  
Age Range ◽  
Arthroplasty Surgery

Category: Ankle Introduction/Purpose: With the increase in number of total ankle arthroplasty surgery, physician guidelines on when to begin to consider patients’ return to driving is valuable. The ability to accurately and efficiently determine when a patient can return to driving is important both from a patient safety and a medicolegal perspective. The purpose of the study was to determine when patients’ brake reaction time (BRT) returns to a safe value after right total ankle arthroplasty. We also aimed to identify predictive factors that may identify those patients who may not be safe to drive. Methods: After institutional review board approval, fifty-five patients undergoing right total ankle arthroplasty were recruited prospectively. Patient demographics include an age range of 43 to 83 years (median 63 years), of which 31 were male (56%) and 24 were female (44%). BRT was tested at six weeks and repeated weekly until patients achieved a passing BRT. A control group of twenty healthy patients was used to establish a passing BRT of 0.850 seconds. Patients were given a validated, novel driver readiness survey to complete of which a 10/15 point or higher score was considered passing. Results: At 6 weeks, 50 patients (91%) achieved a passing BRT and were considered safe to drive, and the passing group average BRT was 0.662 seconds. At 9 weeks, 52 patients (100%) of those who completed the study achieved a passing BRT. Patients that failed at 6 weeks had statistically greater visual analog scale (VAS) for pain (p=0.037) and significantly diminished ankle plantarflexion (p=0.029). There is a significant (p<0.001) and large (r=-0.455) correlation between BRT and the validated driver readiness survey scores. 5/5 (100%) patients that failed the BRT also failed the driver readiness survey (p=0.049). Interestingly, males were more likely to think they were ready to drive based on their driver readiness survey but were no more likely to pass the BRT than females (p=0.002). Conclusion: Over 90% of patients may be eligible to return to driving as early as 6 weeks post-operatively. Indications that a patient is not safe to return to driving at 6 weeks are higher VAS, limited plantarflexion, and a failed driver readiness survey. Although many factors determine whether a patient may safely return to driving, patients may be informed that BRT normalizes 9 weeks after right total ankle arthroplasty.

Molecular Alterations in Pulmonary Adenocarcinoma of African Americans

2019 ◽  
Vol 152 (2) ◽  
pp. 237-242
Author(s):  
Erika F Rodriguez ◽  
Robert Jones ◽  
C Paul Morris ◽  
David Ettinger ◽  
Sayanan Chowsilpa ◽  
...  
Keyword(s):  
Overall Survival ◽  
African American ◽  
African Americans ◽  
Pulmonary Adenocarcinoma ◽  
Institutional Review Board ◽  
Control Group ◽  
Molecular Alterations ◽  
Molecular Tests ◽  
Institutional Review Board Approval ◽  
Institutional Review

ABSTRACT Objectives Identify molecular alterations in pulmonary adenocarcinoma (ADC) in African American (AA) patients diagnosed on cytology specimens. Methods After institutional review board approval, we searched our database from 2013 to 2017 for AA patients with a diagnosis of pulmonary ADC. Molecular and clinical data were reviewed. White patients also diagnosed with pulmonary ADC on cytology samples formed a control group. Results A total of 113 patients were identified. Mean age was 63.4 years. Molecular tests were available for 91 patients. Mutations were identified in 53 (58.2%) cases. The most common mutations were EGFR (n = 19 cases, 36%) and KRAS (n = 24 cases, 45%). When compared with whites, AA patients were diagnosed at higher stages (P = .045) and demonstrated shorter overall survival (17 vs 47 months, P = .0150). No differences were noted regarding distribution of molecular alterations. Conclusion AA patients have similar molecular alterations in ADCs as their white counterparts. However, they have worse outcomes.

Midfoot Function Before and After Total Ankle Arthroplasty

2021 ◽  
pp. 107110072199578
Author(s):  
Frank E. DiLiberto ◽  
Steven L. Haddad ◽  
Steven A. Miller ◽  
Anand M. Vora
Keyword(s):  
Cohort Study ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
Peak Power ◽  
Nonparametric Tests ◽  
Total Ankle Arthroplasty ◽  
Control Group ◽  
Ankle Arthroplasty ◽  
First Metatarsal ◽  
Before And After

Background: Information regarding the effect of total ankle arthroplasty (TAA) on midfoot function is extremely limited. The purpose of this study was to characterize midfoot region motion and power during walking in people before and after TAA. Methods: This was a prospective cohort study of 19 patients with end-stage ankle arthritis who received a TAA and 19 healthy control group participants. A motion capture and force plate system was used to record sagittal and transverse plane first metatarsal and lateral forefoot with respect to hindfoot motion, as well as sagittal plane midfoot region positive and negative peak power during walking. Parametric or nonparametric tests to examine differences and equivalence across time were conducted. Comparisons to examine differences between postoperative TAA group and control group foot function were also performed. Results: Involved-limb midfoot function was not different between the preoperative and 6-month postoperative time point in the TAA group (all P ≥ .17). Equivalence testing revealed similarity in all midfoot function variables across time (all P < .05). Decreased first metatarsal and lateral forefoot motion, as well as positive peak power generation, were noted in the TAA group postoperative involved limb in comparison to the control group (all P ≤ .01). Conclusion: The similarity of midfoot function across time, along with differences in midfoot function in comparison to controls, suggests that TAA does not change midfoot deficits by 6 months postoperation. Level of Evidence: Level II, prospective cohort study.

The Mobile Thriving Respite With and for the Street Community

2021 ◽  
pp. 002216782110467
Author(s):  
Robert McInerney ◽  
Kelsey Long ◽  
Rachel Stough
Keyword(s):  
Lived Experiences ◽  
Institutional Review Board ◽  
Short Term ◽  
Community Based ◽  
Bearing Witness ◽  
Institutional Review Board Approval ◽  
Institutional Review ◽  
Emergent Strategy ◽  
The Creation ◽  
Theoretical Foundations

We report on our work with the street community of Pittsburgh, specifically, a community-based action initiative we call the Mobile Thriving Respite (Institutional Review Board approval was obtained from our university). For 5 years, student advocate ethnographers from Point Park University have gathered data (e.g., long- and short-term interviews, participant-observations generating fieldnotes). The data revealed and supported the need for thriving beyond surviving homelessness. The data endorsed the creation of the mobile thriving respite. In the first part of this work, we will discuss some critical concepts regarding homelessness as a phenomenon and then argue that while surviving as enduring is necessary, there are some for whom survival is a perpetual, lethal state of being. We will discuss the theoretical foundations to the respite and offer researchers’ ethnographic accounts of the respite’s process and progress (We had to temporarily end the respite during the Covid-19 pandemic. To date, the respite has returned with “pop up” events outside at various locations). We will outline how the mobile thriving respite is a praxis as site of resistance as well as an emergent strategy, and an instantiation of communitas. We will then revisit surviving as collectively bearing witness and testifying to the lived experiences of those living outside.

scholarly journals Bone Mineral Density in Gravida: Effect of Pregnancies and Breast-Feeding in Women of Differing Ages and Parity

2014 ◽  
Vol 2014 ◽  
pp. 1-7 ◽  
Author(s):  
Ehud Lebel ◽  
Yuri Mishukov ◽  
Liana Babchenko ◽  
Arnon Samueloff ◽  
Ari Zimran ◽  
...  
Keyword(s):  
Bone Mineral Density ◽  
Bone Mineral ◽  
Institutional Review Board ◽  
Mineral Density ◽  
X Ray ◽  
Normal Limits ◽  
Institutional Review Board Approval ◽  
Institutional Review ◽  
History Of ◽  
Breast Fed

Changes of bone during pregnancy and during lactation evaluated by bone mineral density (BMD) may have implications for risk of osteoporosis and fractures. We studied BMD in women of differing ages, parity, and lactation histories immediately postpartum for BMD,T-scores, andZ-scores. Institutional Review Board approval was received. All women while still in hospital postpartum were asked to participate. BMD was performed by dual-energy X-ray absorptiometry (DXA) machine at femoral neck (FN) and lumbar spine (LS) by a single technician. Of 132 participants, 73 (55.3%) were ≤30 years; 27 (20.5%) were primiparous; 36 (27.3%) were grand multiparous; 35 (26.5%) never breast fed. Mean FNT-scores andZ-scores were higher than respective mean LS scores, but all means were within the normal limits. Mean LST-scores andZ-scores were highest in the grand multiparas. There were only 2 (1.5%) outliers with lowZ-scores. We conclude that, in a large cohort of Israeli women with BMD parameters assessed by DXA within two days postpartum, meanT-scores andZ-scores at both the LS and FN were within normal limits regardless of age (20–46 years), parity (1–13 viable births), and history of either no or prolonged months of lactation (up to 11.25 years).

scholarly journals Feasibility of an Internet-Based Global Ranking Instrument

2011 ◽  
Vol 3 (1) ◽  
pp. 67-74 ◽  
Author(s):  
Seshadri C Mudumbai ◽  
David M Gaba ◽  
John Boulet ◽  
Steven K Howard ◽  
M. Frances Davies
Keyword(s):  
Institutional Review Board ◽  
University Teaching ◽  
Tertiary Referral ◽  
Single Item ◽  
Global Ranking ◽  
Online Technologies ◽  
Institutional Review Board Approval ◽  
Institutional Review ◽  
Referral Hospitals ◽  
Global Ratings

Abstract Background Single-item global ratings are commonly used at the end of undergraduate clerkships and residency rotations to measure specific competencies and/or to compare the performances of individuals against their peers. We hypothesized that an Internet-based instrument would be feasible to adequately distinguish high- and low-ability residents. Materials and Methods After receiving Institutional Review Board approval, we developed an Internet-based global ranking instrument to rank 42 third-year residents (21 in 2008 and 21 in 2009) in a major university teaching hospital's department of anesthesiology. Evaluators were anesthesia attendings and nonphysicians in 3 tertiary-referral hospitals. Evaluators were asked this ranking question: “When it comes to overall clinical ability, how does this individual compare to all their peers?” Results For 2008, 111 evaluators completed the ranking exercise; for 2009, 79 completed it. Residents were rank-ordered using the median of evaluator categorizations and the frequency of ratings per assigned relative performance quintile. Across evaluator groups and study years, the summary evaluation data consistently distinguished the top and bottom resident cohorts. Discussion An Internet-based instrument, using a single-item global ranking, demonstrated feasibility and can be used to differentiate top- and bottom-performing cohorts. Although ranking individuals yields norm-referenced measures of ability, successfully identifying poorly performing residents using online technologies is efficient and will be useful in developing and administering targeted evaluation and remediation programs.

scholarly journals Cerebral Air Emboli Differentially Alter Outcome after Cardiopulmonary Bypass in Rats Compared with Normal Circulation

2007 ◽  
Vol 107 (5) ◽  
pp. 768-775 ◽  
Author(s):  
Bettina Jungwirth ◽  
Kristine Kellermann ◽  
Manfred Blobner ◽  
Wolfgang Schmehl ◽  
Eberhard F. Kochs ◽  
...  
Keyword(s):  
Cardiac Surgery ◽  
Cardiopulmonary Bypass ◽  
Institutional Review Board ◽  
Dose Effect ◽  
Regression Analyses ◽  
Institutional Review Board Approval ◽  
Institutional Review ◽  
Dependent Relation ◽  
Dose Dependent ◽  
Dose Escalating

Background Cerebral air emboli (CAE) are thought to contribute to adverse cerebral outcomes following cardiac surgery with cardiopulmonary bypass (CPB). This study was designed to investigate the effect of escalating volumes of CAE on survival and neurologic and histologic outcomes. In addition, the effect of xenon administration during CAE on these outcomes was determined. Methods With institutional review board approval, four groups were studied (n = 15). In two CPB-CAE groups, rats were subjected to 90 min CPB with 10 repetitively administered CAE. Rats in two sham-CAE groups were also exposed to CAE but not to CPB. Rats were randomly assigned to sequential dose cohorts receiving CAE ranging from 0.2 to 10 microl in a dose-escalating fashion. Groups were further subdivided into xenon (56%) and nitrogen groups. Rats with severe neurologic damage were killed; others were neurologically tested until postoperative day 7, when infarct volumes were determined. Survival and neurologic and histologic outcomes were tested with logistic regression analyses (P &lt; 0.05). Results This study demonstrates a dose-dependent relation between CAE volumes and survival, neurologic outcome, and histologic outcome. For all outcomes, CPB adversely affected the dose-effect curves compared with sham-CAE groups (P &lt; 0.05). Xenon demonstrated no impact on either outcome. Conclusions This study describes the successful incorporation of CAE in a rodent CPB model and allows identifying suitable CAE volumes for subsequent studies. CAE exhibit a differential effect on outcome in rats undergoing CPB versus those not exposed to CPB. Perioperative administration of xenon remained without any effect on outcome.

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