scholarly journals Predictors of Spring Ligament Degeneration and Outcomes of Reconstruction during Correction of Adult Acquired Flatfoot Deformity

2020 ◽  
Vol 5 (4) ◽  
pp. 2473011420S0039
Author(s):  
Steven M. Raikin ◽  
Ryan G. Rogero ◽  
Jared Raikin ◽  
Daniel Corr ◽  
Justin Tsai
Keyword(s):  
Regression Analysis ◽  
Multiple Logistic Regression Analysis ◽  
Functional Score ◽  
Tibialis Posterior ◽  
Foot And Ankle ◽  
Patient Age ◽  
Spring Ligament ◽  
Radiographic Parameters ◽  
Patient Âgé ◽  
Adult Acquired Flatfoot Deformity

Category: Hindfoot; Midfoot/Forefoot Introduction/Purpose: It is currently unclear how injury to the spring ligament (SL) affects the preoperative presentation of adult acquired flatfoot deformity (AAFD). The purposes of this study were to retrospectively identify shared factors that could be used to preoperatively predict SL damage in patients undergoing AAFD correction as well as compare outcomes of patients undergoing SL reconstruction to those not undergoing reconstruction during AAFD correction. Methods: All patients undergoing operative correction of grade 2B AAFD secondary to tibialis posterior tendon dysfunction by a single fellowship-trained foot and ankle orthopaedic surgeon from 2011 to 2017 were reviewed. Operative reports were reviewed for the surgeon’s evaluation of the competency of the SL and to determine whether SL reconstruction was performed. Patient charts were reviewed for demographic information, preoperative Visual Analog Scale (VAS) pain level, and their Foot and Ankle Ability Measure (FAAM) Activities of Daily Living (ADL) and -Sports subscales. Preoperative radiographic parameters were assessed by a surgeon blinded to the intraoperative findings. Patient outcomes of VAS pain, FAAM-ADL, and FAAM-Sports were collected at a minimum of 24 months postoperatively. Multiple logistic regression analysis was performed to determine significant independent predictors of spring ligament tears. Results: The study included 115 feet undergoing corrective reconstruction, with 47 feet having a spring ligament tear (40.9%). Patients with tears were significantly older (p<0.001), with higher preoperative reported pain (p=0.01), and lower preoperative FAAM-ADL (p=0.04) and -Sports (p=0.006) scores than those without SL tears. Patients with a SLT demonstrated significant differences in AP talo-1st MT angle (p=.003), talonavicular uncoverage percentage (p<0.001), talonavicular angle (p=0.017), and Meary`s talo-1st MT angle (p=0.001). Based on multiple logistical regression analysis (odds ratio [95% confidence interval]), patient age (1.10 [1.03, 1.18]; p=0.003), talonavicular uncoverage percentage (1.35 [1.13, 1.60]; p<0.001), and talonavicular angle (0.82 [0.71, 0.96]; p=0.0133) were independently predictive of ligament degeneration. Patients undergoing SL reconstruction did not differ significantly in functional score improvements compared to those without reconstruction. Conclusion: Our findings suggest that a SLT is associated with more advanced flexible pes planovalgus, measured both by radiographic parameters as well as its impact on patient function. Increasing patient age, increasing talonavicular uncoverage percentage, and decreasing talonavicular angle are all independently associated with increased likelihood of patients with AAFD having a SLT. AAFD correction with concomitant SL reconstruction does not appear to influence absolute or changes in patient pain and function. [Table: see text]

Outcomes of 2B Adult Acquired Flatfoot Deformity Correction in Patients With and Without Spring Ligament Tear

2021 ◽  
pp. 107110072110272
Author(s):  
Steven M. Raikin ◽  
Ryan G. Rogero ◽  
Jared Raikin ◽  
Daniel O. Corr ◽  
Justin Tsai
Keyword(s):  
Deformity Correction ◽  
Control Group ◽  
Foot And Ankle ◽  
Level Of Evidence ◽  
Patient Age ◽  
Postoperative Function ◽  
Spring Ligament ◽  
Patient Âgé ◽  
Adult Acquired Flatfoot Deformity

Background: It is currently unclear how injury to the spring ligament (SL) affects the preoperative presentation of adult acquired flatfoot deformity (AAFD) or the outcome of operative reconstruction. The purposes of this study were to assess the preoperative features and pre- or postoperative function of patients who underwent direct operative repair of an SL tear compared to those without a tear. Methods: 86 patients undergoing operative correction of grade 2B AAFD by a single fellowship-trained foot and ankle orthopedic surgeon were reviewed at an average follow-up of 45.9 months. There were 35 feet found to have an SL tear that underwent concomitant debridement and direct repair of the SL. Patient charts were reviewed for demographic information, preoperative visual analog scale (VAS) pain level, and their Foot and Ankle Ability Measure (FAAM) activities of daily living (ADL) and sports subscales. Preoperative radiographic parameters were assessed. Patient outcomes of VAS pain, FAAM-ADL, and FAAM-Sports were collected and compared between groups. Results: Those with an SL tear had significantly lower FAAM-ADL and sports scores, with higher VAS pain scores preoperatively. Patient age, talonavicular uncoverage percentage, and talonavicular angle were found to be associated with spring ligament degeneration. At final follow-up, patients demonstrated a significant improvement in all outcome parameters, with no statistical difference found with patient satisfaction, final postoperative VAS pain, FAAM-ADL, or FAAM-Sports in those requiring a repair of their SL as compared to the control group. Conclusion: Increasing patient age, increasing talonavicular uncoverage percentage, and decreasing talonavicular angle are all independently associated with increased likelihood of patients with AAFD having an SL tear. At follow-up for operative treatment of grade 2B AAFD flatfoot with our approach, we found no clinical outcomes difference between those without SL tears and those with SL tears treated with concomitant SL debridement and repair. Level of Evidence: Level III, retrospective cohort study.

scholarly journals Lateral open wedge calcaneus osteotomy with bony allograft augmentation in adult acquired flatfoot deformity. Clinical and radiological results

2021 ◽  
Author(s):  
Gabriele Colo’ ◽  
Mattia Alessio Mazzola ◽  
Giulio Pilone ◽  
Giacomo Dagnino ◽  
Lamberto Felli
Keyword(s):  
Range Of Motion ◽  
Case Series ◽  
Deformity Correction ◽  
Tibialis Posterior ◽  
Open Wedge ◽  
Foot And Ankle ◽  
Retrospective Case ◽  
Level Of Evidence ◽  
Adult Acquired Flatfoot Deformity

Abstract The aim of this study is to evaluate the results of patients underwent lateral open wedge calcaneus osteotomy with bony allograft augmentation combined with tibialis posterior and tibialis anterior tenodesis. Twenty-two patients underwent adult-acquired flatfoot deformity were retrospectively evaluated with a minimum 2-year follow-up. Radiographic preoperative and final comparison of tibio-calcaneal angle, talo–first metatarsal and calcaneal pitch angles have been performed. The Visual Analog Scale, American Orthopedic Foot and Ankle Score, the Foot and Ankle Disability Index and the Foot and Ankle Ability Measure were used for subjective and functional assessment. The instrumental range of motion has been also assessed at latest follow-up evaluation and compared with preoperative value. There was a significant improvement of final mean values of clinical scores (p < 0.001). Nineteen out of 22 (86.4%) patients resulted very satisfied or satisfied for the clinical result. There was a significant improvement of the radiographic parameters (p < 0.001). There were no differences between preoperative and final values of range of motion. One failure occurred 7 years after surgery. Adult-acquired flatfoot deformity correction demonstrated good mid-term results and low recurrence and complications rate. Level of evidence Level 4, retrospective case series.

scholarly journals The Impact of Patient Age on Foot and Ankle Arthrodesis Supplemented with Autograft or an Autograft Alternative (rhPDGF-BB/β-TCP)

2020 ◽  
Vol 5 (4) ◽  
pp. e20.00056-e20.00056
Author(s):  
Gregory C. Berlet ◽  
Judith F. Baumhauer ◽  
Mark Glazebrook ◽  
Steven L. Haddad ◽  
Alastair Younger ◽  
...  
Keyword(s):  
Ankle Arthrodesis ◽  
Foot And Ankle ◽  
Patient Age ◽  
Patient Âgé ◽  
The Impact

The association of epidermal growth factor receptor (EGFR) polymorphisms and clinicopathological factors with skin rash on gefitinib use

2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 18118-18118
Author(s):  
C. Huang ◽  
C. Yang ◽  
K. Yeh ◽  
F. Hu ◽  
Z. Lin ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Regression Analysis ◽  
Skin Rash ◽  
Logistic Regression Analysis ◽  
Tumor Response ◽  
Multivariate Logistic Regression ◽  
Patient Age ◽  
Short Allele ◽  
Patient Âgé ◽  
Gefitinib Treatment

18118 Background: Skin rash is the most common toxicity of EGFR-targeted therapy. Skin rash of EGFR inhibitor is associated with longer survival or tumor response. However, the clinical and genetic factors associated with this skin rash are not well understood. Methods: Fifty-two non-small-cell lung cancer patients enrolled in a prospective clinical trial of first-line gefitinib treatment were genotyped for EGFR intron 1 CA repeat polymorphism (CAn) and single nucleotide polymorphisms at promoters G-216T, C-191A, and R521K. Grade 2 to 3 skin rash within 4 weeks of treatment (early G2/3 rash) was correlated with the genotype and clinicopathological features of the patients by multivariate logistic regression. Results: Seventeen patients (32.7%) developed early G2/3 rash. In multivariate logistic regression analysis, only the CAn genotype was associated with early G2/3 rash and the effect was modified by patient age. Early G2/3 rash developed in 21% of patients with homozygous long allele (19 to 22 repeats, L) genotype (4/19), 31% of heterozygous short allele (15 to 18 repeats, S) / L genotype (8/26), and 71% of S/S genotype (5/7), respectively. The median ages of patients with early G2/3 rash and patients without early G2/3 rash were 57 years (range: 39–77) and 69 years (range: 43–86), respectively. The estimated logarithm of odds ratio (ln OR) for early G2/3 rash, as compared to S/S genotype, for S/L genotype was -0.038 multiplied by patient age (P = 0.011); and the ln OR for L/L genotype was -0.050 multiplied by patient age (P = 0.004). Fifty patients were evaluable for response. In logistic regression analysis, early G2/3 rash correlated with tumor response (P = 0.027). However, the CAn genotype was not significantly correlated with tumor response (P = 0.43). Conclusions: Homozygous short allele of EGFR CAn is more likely to develop skin rashes on gefitinib treatment. Genotyping of EGFR CAn appears to be a useful predictive marker for development of skin rashes on gefitinib use. [Table: see text]

scholarly journals The Impact of Age and Graft Type on Foot and Ankle Arthrodesis Fusion Success

2020 ◽  
Vol 5 (4) ◽  
pp. 2473011420S0012
Author(s):  
Gregory C. Berlet ◽  
Judith F. Baumhauer ◽  
Mark A. Glazebrook ◽  
Alastair S. Younger ◽  
David Fitch ◽  
...  
Keyword(s):  
Bone Graft ◽  
Significant Risk ◽  
Significant Risk Factor ◽  
Ankle Arthrodesis ◽  
Osteogenic Potential ◽  
Foot And Ankle ◽  
Patient Age ◽  
Patient Âgé ◽  
Significant Difference ◽  
The Impact

Category: Ankle; Ankle Arthritis; Basic Sciences/Biologics; Hindfoot Introduction/Purpose: A recent survey of 100 international foot and ankle orthopaedic surgeons revealed that patient age greater than 60 years is not considered to be a significant risk factor for nonunion following foot and ankle arthrodesis. This finding was surprising as published basic science research shows that autologous bone graft used during fusion surgery may be less effective when harvested from older patients due to both diminished osteogenic potential and migration capacity of mesenchymal stem cells. The purpose of this study was to evaluate the impact of patient age and graft type on fusion rates following hindfoot and ankle arthrodesis. Methods: A Level 1 clinical trial was performed comparing fusion success in 397 hindfoot or ankle arthrodesis subjects (597 joints) supplemented with either autograft or an osteoinductive recombinant human protein derived growth factor (rhPDGF- BB/β-TCP) bone graft substitute. Fusion status was determined using computed tomography, with fusion defined as evidence of at least 50% osseous bridging. In this secondary analysis of that dataset, the odds of fusion success were compared for joints in autograft subjects older or younger than the following age thresholds: 55, 60, 65, 70 and 75 years. This analysis was then repeated for joints in rhPDGF-BB/β-TCP subjects. Finally, odds of fusion success were also compared for the autograft and rhPDGF-BB/β- TCP groups for subjects older than each threshold age. Results: Joints in autograft subjects younger than 60 and 65 years exhibited over two times the odds of fusion as those in older subjects (60 years: OR 2.24, p=0.003; 65 years: OR 2.74, p<0.001). There was no significant difference for other intervals (55 years: OR 1.45, p=0.106; 70 years: 1.64, p=0.096; 75 years: OR 1.28, p=0.335). Interestingly, there was no significant difference for the rhPDGF-BB/β-TCP group at any threshold (55 years: OR 0.86, p=747; 60 years: OR 0.86, p=0.739; 65 years: 1.08, p=0.367; 70 years: 0.94, p=0.588; 75 years: OR 0.70, p=0.809). When odds of fusion were compared for the two groups in subjects older than each age threshold, rhPDGF-BB/β-TCP had approximately two times the odds of fusion success for all except 55 years (Figure 1). Conclusion: This study indicates that age is an identifiable and potentially concerning risk for nonunion following hindfoot or ankle arthrodesis. These findings are in contrast to the wider perception of the surgeon community, as documented in the published survey. Notably, patients over the age of 60 years who are supplemented with autograft have statistically lower odds of fusion compared to those younger, a difference not seen with the use of recombinant technology. This analysis suggests that use of rhPDGF-BB/β-TCP as an alternative bone healing adjunct may help mitigate the risk of nonunion when these procedures are performed in the elderly population.

scholarly journals Increasing Values of the Lateral Talar-First Metatarsal Angle Preoperatively Predict Spring Ligament Attenuation in Adult Acquired Flat Foot Deformity

2019 ◽  
Vol 4 (4) ◽  
pp. 2473011419S0033
Author(s):  
Matthew Pate ◽  
Jacob Hall ◽  
Patrick Albright ◽  
Donald Bohay ◽  
John Anderson ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Predictive Value ◽  
Foot And Ankle ◽  
Foot Deformity ◽  
Flat Foot ◽  
Ligament Tear ◽  
First Metatarsal ◽  
Spring Ligament ◽  
Radiographic Parameters ◽  
Metatarsal Angle

Category: Ankle, Hindfoot, Trauma Introduction/Purpose: Adult acquired flat foot deformity (AAFD) is responsible for numerous adult foot and ankle deformities, and spring ligament damage has been implicated in the pathology of AAFD. Treatment of AAFD may involve attempts to address spring ligament incompetency, and preoperative knowledge of spring ligament integrity would be valuable in planning for such procedures. To our knowledge, there have been no attempts to correlate preoperative radiographs with direct intraoperative evaluation of spring ligament competency. This study aims to examine the relationship between preoperative radiographic measures specific to flatfoot deformity and intraoperative competency of the spring ligament during flatfoot reconstruction in order to find radiographic measures predicting spring ligament attenuation. Methods: The operative reports of 3 fellowship trained orthopaedic foot and ankle surgeons were searched over a 5-year period from 2012-2017. Patients with pre-operative standing AP and lateral radiographs along with an operative report directly visualizing and commenting on spring ligament integrity were included in the study. Investigators reviewed operative reports to identify patients with spring ligament tears and evaluated pre-operative radiographs. Five common radiographic parameters were measured: lateral talar-first metatarsal angle, AP talar-first metatarsal angle, talonavicular coverage angle, talonavicular coverage percentage, and calcaneal pitch. Chi-square and logistic regression analysis were used to evaluate the five radiographic parameters for association with spring ligament tear. Results: The study enrolled 58 patients with 29 patients having confirmed spring ligament tears and 29 patients having an intact spring ligament. Increasing values for each of the 5 radiographic measures were statistically significant predictors for spring ligament tear on univariate analysis (p=0.001) with the lateral talar-first metatarsal angle being the most significant predictor for spring ligament tear (p<0.001). On logistic regression analaysis, LT-1st angle was a significant predictor of spring ligament tear (p<0.001). A lateral talar-first metatarsal angle =30 degrees had a sensitivity and specificity of 65% and 100% for spring ligament attenuation. The positive predictive value of spring ligament tear with a lateral talar-first metatarsal angle =30 degrees was 100% and the negative predictive value was 74%. Conclusion: This study is the first to correlate preoperative radiographs with direct visualization and evaluation of spring ligament competency. Increasing severity of common radiographic measures of flat foot deformity, particularly the lateral talar-first metatarsal angle, correlate significantly with spring ligament tear and may assist surgeons in planning appropriate preoperative interventions.

scholarly journals Outcomes after Tibiocalcaneonavicular Ligament Reconstruction in Stage IIB and Stage IV Adult Acquired Flatfoot Deformity

2020 ◽  
Vol 5 (4) ◽  
pp. 2473011420S0036
Author(s):  
Rusheel Nayak ◽  
Milap Patel ◽  
Anish R. Kadakia
Keyword(s):  
Patient Reported Outcomes ◽  
Stage Iv ◽  
Deltoid Ligament ◽  
First Metatarsal ◽  
Spring Ligament ◽  
Radiographic Outcomes ◽  
Radiographic Parameters ◽  
Metatarsal Angle ◽  
Patient Reported ◽  
Adult Acquired Flatfoot Deformity

Category: Hindfoot; Ankle; Midfoot/Forefoot Introduction/Purpose: The tibiocalcaneonavicular ligament (TCNL) is formed from the confluence of the superficial deltoid ligament and the superomedial spring ligament. In advanced flexible adult acquired flatfoot deformity (AAFD), progressive strain on the TCNL can lead to spring ligament tears, deltoid insufficiency, and eventual medial peritalar instability. Historically, medial peritalar instability was corrected using calcaneal osteotomy in conjunction with isolated spring or deltoid reconstruction. A recent study (Brodell et al.) demonstrated the efficacy of TCNL reconstruction in patients with medial peritalar instability. The purpose of this study is to add to this literature using patient-reported and radiographic outcomes in patients undergoing TCNL reconstruction. Patient-reported outcomes were collected using Patient Reported Outcomes Measurement Information System (PROMIS) Physical Function (PF) and Pain Interference (PI) surveys. Methods: Sixteen patients (mean age 50.25 years; 11 female, 5 male) who underwent TCNL reconstruction were prospectively identified. TCNL reconstruction was indicated for stage IIB patients (n=13) with large spring ligament tears (>1.5cm on MRI or intraoperatively) or if osseous correction did not provide adequate talonavicular joint correction. TCNL reconstruction was indicated in stage IV patients (n=3) if deltoid reconstruction required additional medial stabilization. No patients underwent lateral column lengthening osteotomies. PROMIS scores were obtained at baseline and at minimum 12-months follow-up (average 16 months). Surgical success was determined using minimum clinically important differences (MCID), defined as improvement greater than one-half the standard deviation of each pre-operative PROMIS domain (PF: +2.9 and PI: -2.5). Pre- and post-operative radiographic parameters were measured: talonavicular uncoverage angle, talonavicular uncoverage percentage, AP talo-first metatarsal angle, Meary’s angle, and medial cuneiform height (MCH). Correlation coefficients determined the relationship between radiographic parameters and PROMIS scores. Results: PROMIS PF scores improved significantly from 38.1+-5.8 to 44.1+-7.1 (p=0.0087). PROMIS PI scores improved significantly from 62.9+-5.1 to 52.3+-8.9 (p=0.0025). Seventy-nine and 77 percent of patients had successful surgeries, as defined by MCIDs in the PROMIS PF and PI domains, respectively. Talonavicular uncoverage percentage and Meary’s angle improved significantly from 34.4+-13.4 to 26.3+-9.9 percent (p=0.0360) and 19.2+-8.8 to 15.3+-6.2 degrees (p=0.0089), respectively. Talonavicular uncoverage angle improved from 29.3+-9.6 to 23.3+-8.0 degrees (p=0.0562), AP talo-first metatarsal angle improved from 15.2+-10.2 to 10.4+-9.0 degrees (p=0.0555), and MCH improved from 13.5+-6.2 to 15.9+-4.8 millimeters (p=0.1374). Post- operative MCH correlated significantly with post-operative PROMIS PF scores (r=0.5941; p=0.0152). Change in AP talo-first metatarsal angle correlated significantly with change in PROMIS PI scores (r=0.5682; p=0.0427). No other correlations were significant. Conclusion: Patients with stage IIB and stage IV AAFD who undergo TCNL reconstructions have excellent patient-reported and radiographic outcomes. Reconstruction of the medial longitudinal arch, as measured by post-operative MCH, is associated with higher post-operative functionality. Surgical correction of midfoot abduction, as measured by change in the AP talo-first metatarsal angle after surgery, is associated with improvements in pain. In patients with medial peritalar instability, TCNL reconstruction can be a valuable technique to correct the sagittal arch, prevent excessive midfoot abduction, and improve pain and functionality.

scholarly journals PROMET: the effect of age on patient outcomes in non-laser transvenous lead extraction

EP Europace ◽  
2021 ◽  
Vol 23 (Supplement_3) ◽  
Author(s):  
Z Akhtar ◽  
A Elbatran ◽  
CT Starck ◽  
L WM Leung ◽  
M Sohal ◽  
...  
Keyword(s):  
Regression Analysis ◽  
Multivariate Regression ◽  
Age Groups ◽  
Multivariate Regression Analysis ◽  
Lead Extraction ◽  
Similar Proportion ◽  
Age Group ◽  
Patient Age ◽  
Patient Âgé ◽  
Two Age Groups

Abstract Funding Acknowledgements Type of funding sources: None. OnBehalf PROMET group Background Cardiac implantable electronic devices (CIEDs) improve morbidity and mortality. This has fuelled an upsurge in implantation of these devices across all patient cohorts, simultaneously increasing the need for transvenous lead extractions (TLE). As the global population expands and life-expectancy extends, TLE will play a significant role in CIED management. Advancing patient age is a recognised risk factor for poor outcomes however the association between patient age and TLE outcomes remains unclear.  We sought to evaluate the relationship between patient age and non-laser TLE outcomes. Method Data of 2205 patients (3849 leads) was collected retrospectively from six high-volume TLE institutes across Europe (PROMET) between January 2005-December 2018. Propensity 1:1 score matching was performed to limit the effects of confounding variables, pairing 353 patients in the &gt;80 years of age category with 353 patients in &lt;80 years of age group. Procedural outcomes were compared between the two age groups and multivariate regression analysis was used for predictors of 30-day mortality. Results In the &lt;80 and &gt;80 years-of-age cohorts, there was a similar proportion of male patients (65.3% vs 67.9%, p = 0.47) treated under general anaesthesia (96.5% vs 93.4%, p = 0.078) for a pre-dominant infectious indication (56.7% vs 60.3%, p = 0.52) but with a higher requirement of the EvolutionTM sheath in the octogenarians (39.4% vs 48.4%, p = 0.015). A similar clinical success per lead was achieved between the two age groups (96.6% vs 98%, &lt;80 vs &gt;80 years, p = 0.245) as was complete lead extraction (95.5% vs 96.6%, &lt;80 vs &gt;80 years, p = 0.44) with a comparable minor complication rate (2.3% vs 3.1%, &lt;80 vs &gt;80 years, p = 0.29) and major complications (1.1% vs 1.4%, &lt;80 vs &gt;80 years, p = 0.74). Thirty-day mortality was higher in the octogenarian cohort than the &lt;80-year-olds without reaching statistical significance (5.4% vs 2.6%, p = 0.08); peri-procedural mortality was similar in both age groups (0.3% vs 0.6%, respectively, p = 0.56). Multivariate regression analysis revealed age (p = 0.013, OR 1.06 [1.01-1.12]), systemic infection (p = 0.026, OR 3.4 [1.16-10.35]) and lead dwell time (p = 0.007, OR 1.01 [1.003-1.017]) increased the odds of 30-day mortality. Conclusion Transvenous lead extraction is similar in efficacy and safety across all age groups. Thirty-day mortality is higher in the advanced age group, signifying the importance of post-procedural management in this cohort.

Rehabilitation outcome following war-related transtibial amputation in Kosovo

2013 ◽  
Vol 38 (3) ◽  
pp. 211-217 ◽  
Author(s):  
Teuta Osmani-Vllasolli ◽  
Hajrije Hundozi ◽  
Nikola Orovcanec ◽  
Blerim Krasniqi ◽  
Ardiana Murtezani
Keyword(s):  
Posttraumatic Stress Disorder ◽  
Posttraumatic Stress ◽  
Stress Disorder ◽  
Multiple Logistic Regression Analysis ◽  
First Grade ◽  
Patient Age ◽  
Rehabilitation Outcome ◽  
Patient Âgé ◽  
Transtibial Amputees ◽  
Relationship Of

Background:Previous literature has suggested that age, level of amputation, residual limb length, comorbidities, mental disorders, and cause of amputation can affect the ability to successfully ambulate with prosthesis.Objectives:The objective of this study was to analyze the predictors that affect the rehabilitation outcome of war-related transtibial amputees and the relationship of these factors with ambulation ability after prosthetic fitting.Study design:Retrospective observational study.Methods:We reviewed the records of 69 war-related transtibial amputees. The rehabilitation outcome was analyzed according to the grade of rehabilitation summarized in three grades. Multiple logistic regression analysis was used to determine the odds of achieving the first rehabilitation grade.Results:The majority of patients with transtibial amputations achieved the first grade of rehabilitation (59.4%). The factors that significantly influenced the achievement of the first grade of rehabilitation were age and absence of posttraumatic stress disorder. For every 1-year increase in patient age, the odds of achieving first grade of rehabilitation decreased by a factor of 0.9. Patients without posttraumatic stress disorder had 12.9 greater odds of achieving the first rehabilitation grade compared to patients with posttraumatic stress disorder.Conclusion:Achievement of the first grade of rehabilitation among war-related transtibial amputees is dependent on patient age and the absence of posttraumatic stress disorder.Clinical relevanceUnderstanding the factors that may affect the rehabilitation outcome of war-related amputees could lead to a more specific organization of the rehabilitation, especially in a country that has recently been involved in war. This is the first study to focus on determinants of prosthetic rehabilitation in these patients.

scholarly journals Prevalence and Degree of Breast Arterial Calcifications on Mammography: A Cross-sectional Analysis

2013 ◽  
Vol 3 ◽  
pp. 36 ◽  
Author(s):  
Norman Loberant ◽  
Vera Salamon ◽  
Nurit Carmi ◽  
Anna Chernihovsky
Keyword(s):  
Regression Analysis ◽  
Statistical Analysis ◽  
Strong Correlation ◽  
Ethnic Origin ◽  
Patient Age ◽  
Cross Sectional ◽  
Cross Sectional Analysis ◽  
Patient Âgé ◽  
Sectional Analysis ◽  
High Degree

Objectives: The purpose of this study is to establish a database including prevalence and degree of breast arterial calcifications (BAC) in our population of women presenting for mammography. Materials and Methods: The mammograms of 1786 women over the age of 40 years were examined for the presence and degree of BAC. Statistical analysis was performed to correlate patient's age and ethnic origin with the presence and degree of BAC. Results: There was statistically significant and strong correlation between the patient's age and presence of BAC. There was also a less strong yet statistically significant correlation between patient age and degree of BAC. Regression analysis showed the likelihood of BAC at various ages. The prevalence of BAC is only 2% of women under 50 years of age; the prevalence of Grade 2-3 BAC is only 1% in women under 60 years of age. Conclusion: There is a predictable increase with age in both prevalence and degree of BAC in women. The presence of high degree BAC in women under 60 years of age or any BAC in women under 50 years of age is unusual.

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