scholarly journals Temporary hemiepiphysiodesis using an eight‐plate implant for coronal angular deformity around the knee in children aged less than 10 years: efficacy, complications, occurrence of rebound and risk factors

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Zhen-Zhen Dai ◽  
Zhen-Peng Liang ◽  
Hao Li ◽  
Jing Ding ◽  
Zhen-Kai Wu ◽  
...  

Abstract Background Temporary hemiepiphysiodesis (TH) using an eight-Plate implant is one of the most common surgeries used for the correction of coronal angular deformities around the knee in adolescents. However, few studies have focused on children aged less than 10 years treated with TH using an eight-Plate implant. The purpose of this study was to investigate the efficacy, correction velocity, and complications of TH with an eight-Plate implant as well as the occurrence of rebound and risk factors in this population. Methods This retrospective study included a total of 135 physes (101 knees) from 66 children (mean age of 4.69 years old, range from 1 to 10 years old) who underwent TH with an eight-Plate implant to correct coronal genu angular deformities in our hospital. Related clinical factors were recorded and analysed by multivariable linear and logistic regression models. Results The mean deformity correction period was 13.26 months, and the mean follow-up after eight-Plate removal was 12.71 months. In all, 94.06% (95/101 knees) of the genu angular deformities were completely corrected. Non-idiopathic genu angular deformity was found to be an independent risk factor for deformity correction failure (odds ratio (OR) = 2.47). The femoral correction velocity was significantly higher than the tibial correction velocity (1.28° vs. 0.83° per month, p < 0.001). After adjustment for other factors, younger children had higher correction velocities in the distal femur; however, genu valgum and idiopathic deformities were associated with higher correction velocities in the proximal tibia. In addition, we found three (3/101, 2.97%) knees with genu valgum that experienced rebound after removal of the eight-Plate, while five (5/101, 4.95%) knees with non-idiopathic genu angular deformity experienced screw loosening. No other complications were found, and non-idiopathic deformity was the only risk factor for complications (OR = 3.96). No risk factor was found for rebound in our study. Conclusions TH using an eight-Plate implant is an effective procedure for coronal genu angular deformities with a low incidence of complications and rebound in patients younger than 10 years old. For this population, TH using an eight-Plate should be considered as soon as the deformity stops responding to conservative treatments. The parents of children younger than 10 years of age with non-idiopathic deformities should be informed preoperatively that the deformity may be prone to correction failure or screw loosening after eight-Plate implantation.

2017 ◽  
Vol 39 (4) ◽  
pp. 685-702 ◽  
Author(s):  
ANNE W. TAYLOR ◽  
RHIANNON PILKINGTON ◽  
ELEONORA DAL GRANDE ◽  
CONSTANCE KOURBELIS ◽  
HELEN BARRY

ABSTRACTBaby boomers who rent are often overlooked as an important sub-group. We aimed to assess the chronic conditions, risk factors, socio-economic factors and other health-related factors associated with renting in private or public housing. Data from telephone interviews conducted each month in South Australia between 2010 and 2015 were combined. Prevalence estimates were assessed for each risk factor and chronic condition by housing status. The association between housing status and variables of interest were analysed using logistic regression models adjusting for multiple covariates (age, gender, income, smoking, physical activity, area and year of data collection). Overall, 17.4 per cent of the 16,687 baby boomers interviewed were renting, either privately or using government-subsided housing. The health profile of renters (both private and public) was poorer overall, with renters more likely to have all of the chronic conditions and ten risk factors assessed. For public renters the relationships were maintained even after controlling for socio-economic and risk factor variables for all chronic diseases except osteoporosis. This research has provided empirical evidence of the considerable differences in health, socio-economic indicators and risk factors between baby boomers who rent and those who own, or are buying, their own homes.


2014 ◽  
Vol 2014 ◽  
pp. 1-7 ◽  
Author(s):  
Gordon S. K. Yau ◽  
Jacky W. Y. Lee ◽  
Victor T. Y. Tam ◽  
Stan Yip ◽  
Edith Cheng ◽  
...  

Purpose.To determine the differences in risk factors for retinopathy of prematurity (ROP) in paired twins.Methods.A retrospective medical record review was performed for all paired twins screened for ROP between 2007 and 2012. Screening was offered to very low birth weight (≤1500 grams) and preterm (≤32 weeks) neonates. Twins 1 and 2 were categorized based on the order of delivery. Maternal and neonatal covariates were analyzed using univariate and multivariate regression analyses for both ROP and Type 1 ROP.Results.In 34 pairs of Chinese twins, the mean gestational age (GA) was 30.2 ± 2.0 weeks. In Twin 1, smaller GA (OR = 0.44,P=0.02), higher mean oxygen concentration (OR = 1.34,P=0.03), presence of thrombocytopenia (OR = 1429.60,P<0.0001), and intraventricular hemorrhage (OR = 18.67,P=0.03) were significant risk factors for ROP. For Twin 2, a smaller GA (OR = 0.45,P=0.03) was the only risk factor. There were no significant risk factors for ROP in Twin 1 or Twin 2 on multivariate analysis.Conclusion.In Chinese twin pairs, smaller GA was the only common risk factor for ROP while Twin 1 was more susceptible to the postnatal risks for ROP.


Author(s):  
Ashwini Shenai ◽  
Savitha G

Objective: Metabolic syndrome (MetS) is a common health problem worldwide. According to third national health and nutrition examination survey criteria, about 47 million people have MetS. It is defined as having three or more of the following five risk factors including abdominal obesity, increased triglyceride levels, low-density lipoprotein cholesterol level, elevated blood pressure, and elevated fasting glucose levels. These components of MetS are major risk factors for the development of chronic kidney disease (CKD) also. CKD is a major public problem and it is a major risk factor for the development of cardiovascular disease. Hence, the aim of the current study was to evaluate the association between MetS and CKD.Methods: A total of 50 patients reporting to Saveetha Dental College and Hospitals were enrolled into the study which includes 25 patients with MetS and 25 healthy individuals. 5 mL of venous blood was collected and centrifuged. Then, it is analyzed for fasting blood sugar (FBS), serum triglycerides, serum urea, and creatinine using the standard kit method. The data obtained were subjected to statistical analysis using the SPSS software.Results: The mean body mass index, FBS, serum creatinine, and triglyceride levels were higher in MetS patients in comparison to healthy individuals. The mean body mass index (BMI), FBS, serum urea, serum creatinine, and triglyceride levels in the control group and MetS group were 27.75±3.67, 84.8±12.5, 17.52±5.2, 0.91±0.17, and 96.5±60.13 and 35.14±4.25, 108.8±34.69, 21.4±5.9, 1.0±0.14, and 239.76±51.21, respectively. There was a significant difference in the mean BMI, FBS, urea, creatinine, and triglyceride levels of the above group.Conclusion: Serum urea and creatinine levels were significantly higher in MetS individuals. Hence, MetS could be a one of the risk factors for the development of CKD.


2013 ◽  
Vol 131 (1) ◽  
pp. 27-34 ◽  
Author(s):  
Orlando Milhomem Mota ◽  
Maria Paula Curado ◽  
José Carlos Oliveira ◽  
Edesio Martins ◽  
Daniela Medeiros Milhomem Cardoso

CONTEXT AND OBJECTIVESEsophageal cancer is the eighth commonest type of cancer worldwide, occupying sixth place in terms of mortality. Smoking and alcohol use are known risk factors for this type of cancer. The aim here was to evaluate the risk factors for esophageal cancer in a low-incidence area.DESIGN AND SETTINGCase-control study in Goiânia, with 99 cases of esophageal cancer and 223 controls.METHODSThe variables were sociodemographic, dietary, occupational and lifestyle data. The sample was analyzed using the chi-square test, Mann-Whitney test and Mantel-Haenszel approach for multivariate analysis. Odds ratios (OR) were calculated with 5% significance and 95% confidence intervals.RESULTSThe risk of esophageal cancer was higher in patients ≥ 55 years (OR = 1.95; P < 0.001). Patients from rural areas were at greater risk of esophageal cancer (OR = 4.9; P < 0.001). Smoking was a risk factor among the cases (OR = 3.8; P < 0.001), as was exposure to woodstoves (OR = 4.42; P < 0.001). The practice of oral sex was not a risk factor (OR = 0.45; P = 0.04). Consumption of apples, pears, vegetables, cruciferous vegetables and fruit juices were protective against esophageal cancer.CONCLUSIONIn a region in which the incidence of esophageal cancer is low, the most significant risk factors were exposure to woodstoves, smoking and living in rural areas.


2020 ◽  
pp. injuryprev-2019-043499
Author(s):  
Elizabeth A Phelan ◽  
Eileen Rillamas-Sun ◽  
Lisa Johnson ◽  
Michael J LaMonte ◽  
David M Buchner ◽  
...  

ObjectiveTo identify the risk factors of women who fell with injury relative to women who did not fall or fell without injury and to describe the circumstances and consequences of injurious and non-injurious falls.MethodsWe analysed 5074 older women from the Objective Physical Activity and Cardiovascular Health Study who prospectively tracked their falls using a 13-month calendar. Women with a reported fall were phone interviewed about fall-related details, including injuries. Risk factors were identified from surveys and clinical home visits. Logistic regression models were used to calculate adjusted ORs and 95% CIs for injurious falls relative to not falling or falling without injury. Circumstances of injurious and non-injurious falls were compared.ResultsAt least one fall was experienced by 1481 (29%) participants. Of these, 1043 were phone interviewed, of whom 430 (41%) reported at least one injurious fall. Relative to not falling, the risk factor most strongly associated with experiencing an injurious fall was having fallen ≥2 times (OR 4.0, CI 2.7 to 5.8) in the past year. Being black was protective for fall-related injury (OR 0.6, CI 0.4 to 0.9). No strong associations in risk factors were observed for injurious relative to non-injurious falls. Injurious falls were more likely to occur away from and outside of the home (p<0.05). Over half of those who injured self-managed their injury.ConclusionFalling repeatedly is a powerful risk factor for injurious falls. Those who have fallen more than once should be prioritised for interventions to mitigate the risk of an injurious fall.


2019 ◽  
Vol 12 (7) ◽  
pp. 1085-1092
Author(s):  
E. K. Kathambi ◽  
J. A. VanLeeuwen ◽  
G. K. Gitau ◽  
C. Kamunde

Background and Aim: The welfare of animals kept in livestock production systems has raised concerns around the world. Adult dairy cattle require adequate rest and spend approximately 12 h/day lying down. This cross-sectional study aimed to determine the stall factors and management practices affecting cows' lying time, stall cleanliness, and cows' cleanliness (udder and upper leg), in smallholder dairy cows in Meru County of Kenya. Materials and Methods: A total of 106 milking cows from 73 farms were assessed for daily lying time and cleanliness. Data loggers were used to record the lying time of cows for 3 days. Stall, udder, and upper leg cleanliness were assessed using a 5-score system: 1 (very clean) to 5 (very dirty). Management information was acquired using a questionnaire that was administered face-to-face to the farmers in their native Kimeru language. Univariable and multivariable linear and logistic regression models were fit to determine factors associated with cows' lying time and dichotomized stall and cows' own cleanliness, respectively. Results: The mean daily lying time was 10.9±2.2 h, and the mean stall cleanliness score was 2.4±1.0. The mean average cleanliness scores of the udder and upper legs were 1.9±0.7 and 2.5±1.1, respectively. Overall, 35% of the stalls were categorized as dirty (>2.5), whereas 13% and 47% of the cows had udder and leg cleanliness scores >2.5, respectively. From the final multivariable models (p<0.05), daily lying time increased by 1.0 h for cows older than 5.25 years versus younger cows. Conversely, lying time decreased by 1.0 h with stall cleanliness scores >2.5 and by 1.6 h with poorly positioned neck rails. In an interaction term, addition of new bedding at least once a day without removing stall manure at least once a day decreased the daily lying time of the cows by 1.5 h, whereas failure to add new bedding at least once a day but removing stall manure at least once a day decreased the lying time of the cows by 1.2 h. Farm-level risk factors for stall dirtiness (>2.5) included delayed cleaning of the alley (odds ratio [OR]=6.6, p=0.032), lack of bedding (OR=4.9, p=0.008), and standing idle and/or backward in the stall (OR=10.5, p=0.002). Stalls categorized as dirty (OR=2.9, p=0.041) and lack of bedding (OR=2.7, p=0.065) were cow- and farm-level risk factors for dirtiness of the udder (>2.5), respectively, whereas the stall being dirty (OR=2.3, p=0.043) was the only risk factor (cow level) for dirtiness of the upper legs (>2.5). Conclusion: It was recommended that farmers should pay attention to the specific factors identified regarding the stall design (e.g., neck rail position) and bedding/manure management that impact the cleanliness of cows and their lying time.


2021 ◽  
Vol 12 (1) ◽  
pp. 69-76
Author(s):  
Rico Januar Sitorus ◽  
Nyoman Yudi Antara ◽  
Rosyada Elviani ◽  
Zen Ahmad ◽  
Harun Hudari ◽  
...  

World Health Organization (WHO) has declared the novel corona virus (COVID-19) as a pandemic due to its high transmission and the rapid spread of the COVID-19. Along these lines, there is a need for more research about risk factors that can affect the spread of COVID-19 and its fatality. Therefore, this study aims to analyze risk factors in patients who died from COVID-19 at the Mohammad Hoesin Hospital in Palembang, South Sumatra, Indonesia. This study used a cross-sectional approach. The data were collected from all patients who died with suspected, probable, and confirmed status until September 2020  Data on death due to COVID-19 were collected with suspect, probable, and confirmed status. The results showed that comorbidity became the most dominant factor (62.1%) with (OR Adj) 3.780 (1.000 – 3.168) after controlling for contact history with confirmed cases and sex. There were differences in the mean age and length of stay in patients with confirmed COVID-19 and not. Prevention of death in COVID-19 patients can be done by controlling comorbidities and contact history with positive cases of COVID-19.


2023 ◽  
Vol 83 ◽  
Author(s):  
R. Muzaffar ◽  
M. A. Khan ◽  
M. H. Mushtaq ◽  
M. Nasir ◽  
A. Khan ◽  
...  

Abstract The present study was designed to evaluate the strength of association of raised plasma homocysteine concentration as a risk factor for coronary heart disease independent of conventional risk factor. It was a case control study conducted at Punjab Institute of Cardiology Lahore. A total of 210 subjects aged 25 to 60 years comprising of 105 newly admitted patients of CHD as cases and 105 age and sex matched healthy individuals with no history of CHD as control were recruited for the study. Fasting blood samples were obtained from cases and controls. Plasma homocysteine was analyzed by fluorescence polarization immunoassay (FPIA) method on automated immunoassay analyzer (Abbott IMX). Total cholesterol, triglyceride and HDL cholesterol were analyzed using calorimetric kit methods. The concentration of LDL cholesterol was calculated using Friedewald formula. The patients were also assessed for traditional risk factors such as age, sex, family history of CVD, hypertension, smoking and physical activity, and were compared with control subjects. The collected data was entered in SPSS version 24 for analysis and interpretation.The mean age in controls and experimental groups were 43.00± 8.42 years and 44.72± 8.59 years with statistically same distribution (p- value= 0.144). The mean plasma homocysteine for cases was 22.33± 9.22 µmol/L where as it was 12.59±3.73 µmol/L in control group. Highly significant difference was seen between the mean plasma level of homocysteine in cases and controls (p˂0.001).Simple logistic regression indicates a strong association of coronary heart disease with hyperhomocysteinemia (OR 7.45), which remained significantly associated with coronary heart disease by multivariate logistic regression (OR 7.10, 95%C1 3.12-12.83, p=0.000). The present study concludes that elevated levels of Plasma homocysteine is an independent risk factor for coronary heart disease independent of conventional risk factors and can be used as an indicator for predicting the future possibility for the onset of CVD.


2019 ◽  
Vol 10 (5) ◽  
pp. 598-602
Author(s):  
Laura Marie-Hardy ◽  
Hugues Pascal-Moussellard ◽  
Anne Barnaba ◽  
Raphael Bonaccorsi ◽  
Caroline Scemama

Study Design: Retrospective cohort study. Objective: Screw loosening in spinal fusion is poorly defined. Accordingly, its prevalence rates range from 1% to 60%, and its risk factors remain undefined. The goal of this study was to assess the prevalence of screw loosening, according to precise definitions, and to identify factors associated with it. Methods: We retrospectively reviewed records for 166 patients who underwent a posterior spinal fusion in our institution between 2011 and 2016. We recorded demographic data, osteoporosis, pelvic balance, surgery-related information, and postoperative radiographic data at a minimum follow-up of 6 months. Univariable and multivariable logistic regression models were used. Significance was defined by P < .05. Results: When loosening was defined by partial pull-out, its prevalence was 9.6% (95% CI 5.6-15); thoracic localization, the use of CrCo (chromium-cobalt) rods, osteoporosis, PI/LL (pelvic incidence/lumbar lordosis) mismatch (preoperative), and frontal imbalance (preoperative) were significant risk factors. When loosening was defined by osteolysis (radiolucent rim) >1 mm around at least 1 screw, its prevalence was 40.4% (95% CI 33-48) and age, scoliosis as indication for fusion, ASA (American Society of Anesthesiologists) 2 or 3, the use of CrCo rods, more than 5 levels fused, no circumferential arthrodesis, postoperative bracing, and sacrum or ilium as the inferior level of instrumentation were also significant risk factors. Conclusions: A clear definition of screw loosening seems essential for a useful analysis of the literature. Osteoporosis, sagittal imbalance, and rigid material appear to be risk factors, regardless of the definition.


2018 ◽  
Vol 44 (4) ◽  
pp. E14 ◽  
Author(s):  
Manish Kolakshyapati ◽  
Fusao Ikawa ◽  
Masaru Abiko ◽  
Takafumi Mitsuhara ◽  
Yasuyuki Kinoshita ◽  
...  

OBJECTIVEElderly patients are particularly at risk for severe morbidity following surgery. Among the various risk factors, age and skull base location of meningioma are known to be poor prognostic factors in meningioma surgery. The authors conducted this study to analyze significant preoperative risk factors in elderly patients with skull base meningioma.METHODSA total of 265 elderly patients (≥ 65 years old) with meningioma were surgically treated at the authors’ institute and affiliated hospitals between 2000 and 2016, and these cases were reviewed. Among them, 57 patients with skull base meningioma were evaluated. Among the various risk factors, the authors analyzed age, sex, Karnofsky Performance Scale (KPS) score, American Society of Anesthesiologists score, and tumor size, location, and pathology. Body mass index (BMI) and serum albumin were investigated as the frailty factors. The authors also reviewed 11 surgical studies of elderly patients ≥ 60 years old with meningioma.RESULTSThe mean age was 72.4 ± 5.7 years, and 42 patients were female (73.6%). The mean size of meningioma was 36.6 ± 14.8 mm at the maximum diameter, and the mean follow-up period was 31.1 ± 31.5 months. (The continuous variables are expressed as the mean ± SD.) Histopathological investigation revealed a higher incidence (71.9%) of WHO Grade I. The rates of deterioration after surgery, at 3 months, and at 1 year were 33.3%, 37.3%, and 39.1%, respectively. Univariate analysis revealed location, preoperative KPS score, BMI level 2, and serum albumin level (p = 0.010, 0.017, 0.0012, and 0.0019, respectively) to be poor prognostic factors. Multivariate analysis revealed that location (p = 0.038) and BMI (p = 0.035) were risk factors for KPS score deterioration immediately after surgery. According to the 11 papers reviewed, the median rate (25th–75th percentile) of skull base–related location was 43.5% (39.6–47.75); for asymptomatic status the mean was 24%; and for mortality at 3 months and 1 year the medians were 6.3% (0.7–7.1) and 8% (4.8–9.4), respectively.CONCLUSIONCareful preoperative assessment based on the frailty concept was essential for better outcome in elderly patients with skull base meningioma. The BMI is appropriate as a quantitative factor for measure of frailty, particularly in elderly individuals with skull base meningioma. Further prospective randomized controlled trials are necessary to validate frailty as a preoperative risk factor. Not only patient selection but also surgical timing was an important factor.


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