scholarly journals Radiological tarsal bone morphology in adolescent age of congenital clubfeet treated with the Ponseti method

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Johannes Hamel ◽  
Hubert Hörterer ◽  
Norbert Harrasser
Keyword(s):  
Primary Treatment ◽  
Ponseti Method ◽  
Control Group ◽  
X Rays ◽  
Tarsal Bone ◽  
Motion Segment ◽  
Temporal Course ◽  
Tarsal Bones ◽  
Widespread Acceptance

Abstract Background Major abnormalities of tarsal bone shape after surgical clubfoot treatment are well known from the literature. The Ponseti method has gained widespread acceptance in primary treatment of congenital clubfeet. Despite the longtime experience, data regarding the development of tarsal bones after this treatment are still rare. The aim of the study was therefore to evaluate radiographic parameters describing tarsal bone shape of clubfeet after Ponseti treatment and compare them to age-matched healthy feet. Methods Twenty two consecutive severe clubfeet in 14 patients were investigated by repeated diagnostic ultrasound during the corrective process. Extent and temporal course of correction were documented with standardized X-rays after a mean follow-up of 12 years (between the ages of 10–14 years) and compared to a group of age-matched normal feet. Results Reliability testing for all X-ray parameters showed good to excellent results. In comparison to the control group, all parameters except the radius of the trochlea (RT) were significantly altered in clubfeet with highest differences shown for the anterior talar motion segment (ATM), talonavicular coverage (TNC) and the talometatarsal index (TMT-Index). Differentiation between minor and major deformities showed significant differences only for the front tarsal index (FTI). Conclusions Tarsal bone shape of clubfeet treated by the Ponseti method differs significantly from normal feet. One of the most pronounced and clinically relevant difference of the clubfoot talus compared to the normal talus is the markedly reduced anterior talar motion segment.

scholarly journals The Association of the One-Abutment at One-Time Concept with Marginal Bone Loss around the SLA and Platform Switch and Conical Abutment Implants

2021 ◽  
Vol 11 (1) ◽  
pp. 74
Author(s):  
Nasreen Hamudi ◽  
Eitan Barnea ◽  
Evgeny Weinberg ◽  
Amir Laviv ◽  
Eitan Mijiritsky ◽  
...  
Keyword(s):  
Bone Loss ◽  
Test Group ◽  
Mucosal Barrier ◽  
Control Group ◽  
X Rays ◽  
Marginal Bone Loss ◽  
Bone Level ◽  
The Difference ◽  
The One

Objectives: Repeated abutment disconnection/reconnection may compromise the mucosal barrier and result in crestal bone level changes. The clinical significance of this phenomenon is not yet clear, as most studies on this topic are short-term. Therefore, the aim of the present study was to evaluate the influence of abutment disconnections and reconnections on peri-implant marginal bone loss over a medium-term follow-up period. Material and methods: Twenty-one patients (6 men and 15 women) with a mean age 66.23 ± 9.35 year at the time of implant placement were included. All patients who received two adjacent nonsubmerged implants were randomly assigned into one of the two groups: definitive multiunit abutments (DEFs) connected to the implant that were not removed (test group) or healing abutments (HEAs) placed at surgery, which were disconnected and reconnected 3–5 times during the prosthetic phase (control group). Peri-implant marginal bone levels (MBL) were measured through periapical X-rays images acquired immediately after the surgery (baseline), at 4–7 months immediately after prosthetic delivery, and at 1-year and 3-year follow-up visits. Results: No implant was lost or presented bone loss of more than 1.9 mm during the 3-year follow-up; thus, the survival and success rate was 100%. Peri-implant mucositis was noticed in 38.1% DEFs and 41.9% of HEAs at the 3-year follow-up assessment. At the end of 3 years, the MBL was −0.35 ± 0.69 mm for participants in the DEFs group and −0.57 ± 0.80 mm for the HEAs group, with significant statistical difference between groups. Conclusions: Immediate connection of the multiunit abutments reduced bone loss in comparison with 3–5 disconnections noted in the healing abutments 3 years after prosthetic delivery. However, the difference between the groups was minimal; thus, the clinical relevance of those results is doubtful.

scholarly journals Follow up after Primary Treatment of Soft Tissue Sarcoma: A Survey of Current Practice in the United Kingdom

Sarcoma ◽  
2007 ◽  
Vol 2007 ◽  
pp. 1-6 ◽  
Author(s):  
C. H. Gerrand ◽  
L. J. Billingham ◽  
P. J. Woll ◽  
R. J. Grimer
Keyword(s):  
United Kingdom ◽  
Soft Tissue ◽  
Soft Tissue Sarcoma ◽  
Current Practice ◽  
Primary Treatment ◽  
X Rays ◽  
The United Kingdom ◽  
Clinical Scenarios ◽  
Risk Of Relapse

Despite the clinical and financial implications, there is little evidence about how patients who have been treated for soft tissue sarcoma should be followed up. The purpose of this study was to determine current practice in the United Kingdom. 192 clinicians treating patients with soft tissue sarcoma were surveyed with a postal questionnaire enquiring about frequency and method of follow up and how patients would be followed up in each of 3 clinical scenarios: a patient with a trunk or extremity tumour at low risk of relapse; a patient with a trunk or extremity tumour at high risk of relapse; and a patient with a retroperitoneal or abdominal tumour. 155 (81%) clinicians responded. Clinic visits and X-rays were the most frequently used methods of follow up. Chest CT scans, local site imaging, and blood tests were used infrequently. The intensity and methods of follow up varied with each of the clinical scenarios. There was a seven-to-twenty fold variation in cost between the least and the most expensive regimes. Respondents were generally supportive of the development of the clinical trial in this area.

scholarly journals FRACTURE SHAFT OF FEMUR IN CHILDREN

2016 ◽  
Vol 23 (08) ◽  
pp. 985-990
Author(s):  
Fayyaz Ahmad Orfi ◽  
Saira Shakeel ◽  
Irtiza Bhutta
Keyword(s):  
Conservative Management ◽  
Tertiary Care ◽  
Limb Length Discrepancy ◽  
Control Group ◽  
External Fixators ◽  
X Rays ◽  
Knee Stiffness ◽  
Gait Abnormality ◽  
Tertiary Care Hospitals

This study was carried out to check the efficacy of external fixators as comparedto conservative management in treating fracture shaft of femur in children from 2 to 8 years.Fracture shaft of femur in this age group are usually managed with traction for 2-3 weeksfollowed by hip spicca of 3-4 weeks. It is difficult to achieve good reduction by traction. Thisis not well tolerated by children. Hospital stay is prolonged. Perenial hygiene is difficult andpressure sores are common. LLD (limb length discrepancy), knee stiffness and gait changesare the long term complications associated with conservative management.6 We managed 31cases of fracture shaft of femur in 30 children from the age of 2-8 years with external fixators(ex-fix) and compared the results with 24 cases of fracture femur managed with traction andhip spicca. Study design: Prospective study. Tertiary care hospitals of military at Muzaffarabad,Kharian and Malir. Period: Sep 2008 to Mar 2015. Material & Methods: Informed consent wasobtained. Children from 2 to 8 years were included in this study. AO External fixator with 3.5mm shanze screws was used with 2 screws on each side of fracture. External fixators wereremoved after 8 weeks in most (>90%) of the cases. Patients were discharged on 1st postopday. Results: Observations were made during hospital period and then fortnightly and aminimum follow up of 6 months was done. Union was assessed clinically and on X-rays (3surfaces union). Observations made regarding reduction achieved, complications of procedureand compliance of children. Any LLD, knee stiffness and gait abnormality were noted during the6 months of follow up and compared with 24 cases managed conservatively (control group).

scholarly journals Treatment of non-idiopathic clubfeet with the Ponseti method: a systematic review

2018 ◽  
Vol 12 (6) ◽  
pp. 575-581 ◽  
Author(s):  
T. De Mulder ◽  
S. Prinsen ◽  
A. Van Campenhout
Keyword(s):  
Systematic Review ◽  
Successful Treatment ◽  
Primary Treatment ◽  
Ponseti Method ◽  
Current Evidence ◽  
Level Of Evidence ◽  
Long Term Effect ◽  
Initial Correction ◽  
Meta Analyses

Purpose Although non-idiopathic clubfeet were long thought to be resistant to non-surgical treatment methods, more studies documenting results on treatment of these feet with the Ponseti method are being published. The goal of this systematic review is to summarize current evidence on treatment of non-idiopathic clubfeet using the Ponseti method. Methods PubMed and Limo were searched, reference lists of eligible studies were screened and studies that met the inclusion criteria were included. Data on average number of casts, Achilles tendon tenotomy (ATT), initial correction, recurrence, successful treatment at final follow-up and complications were pooled. The Methodological Index for Non-Randomized Studies was used to assess the methodological quality of the selected studies. Results In all, 11 studies were included, yielding a total of 374 non-idiopathic and 801 idiopathic clubfeet. Non-idiopathic clubfeet required more casts (7.2 versus 5.4) and had a higher rate of ATT (89.4% versus 75.7%). Furthermore, these feet had a higher recurrence rate (43.3% versus 11.5%) and a lower rate of successful treatment at final follow-up (69.3% versus 95.0%). Complications were found in 20.3% of the non-­idiopathic cohort. When comparing results between clubfeet associated with myelomeningocele and arthrogryposis, the first group presented with a lower number of casts (5.4 ­versus 7.2) and a higher rate of successful treatment at final follow-up (81.8% versus 58.2%). Conclusion The Ponseti method is a valuable and non-invasive option in the primary treatment of non-idiopathic clubfeet in young children. Studies with longer follow-up are necessary to evaluate its long-term effect. Level of Evidence Level III – systematic review of Level-III studies. This work meets the requirements of the PRISMA guidelines (Preferred Reporting Items for Systematic Reviews and ­Meta-Analyses).

Resorbable Anterior Cervical Plates for Single-Level Degenerative Disc Disease

2007 ◽  
Vol 61 (suppl_5) ◽  
pp. ONS305-ONS310 ◽  
Author(s):  
Rajesh K. Bindal ◽  
Subrata Ghosh ◽  
Beatrix Foldi
Keyword(s):  
Clinical Outcomes ◽  
Rating Scale ◽  
Control Group ◽  
X Rays ◽  
Titanium Plate ◽  
X Ray ◽  
Single Level ◽  
Plate Group ◽  
Cervical Plate

Abstract Objective: Resorbable spinal implants have generated increasing interest. There are minimal data in the literature on the use of resorbable anterior cervical plates. The purpose of this study is twofold. First, we present clinical outcomes of anterior cervical decompression and fusion (ACDF) for single-level degenerative disease using the first commercially available resorbable cervical plate. Second, we compare x-ray outcomes, including pseudarthrosis rates and angulation of healing, between patients receiving resorbable plates and a control group of patients receiving titanium plates. Methods: Twenty-four consecutive patients treated with single-level ACDF using a resorbable anterior cervical plate were prospectively evaluated with minimum 12-month follow-up (mean, 15 mo). As a control group, 93 consecutive patients treated with single-level ACDF using a titanium plate with minimum 1-year follow-up were assessed. Results: Overall outcomes were good in the resorbable plate group at a mean 15 months follow-up. Neck Disability Index scores decreased from a mean of 64.0 to 20.1% at follow-up (P < 0.001). Numerical Rating Scale pain scores decreased from a mean of 8.0 preoperatively to 2.9 at follow-up (P < 0.001). Three cases of pseudarthrosis [three of 24 (12.5%)] were identified in the resorbable plate group compared with two cases in the control group [two of 93 (2.2%)]. This difference was significant (P = 0.047). Angulation was measured on final x-rays using Cobb angles. Patients in the resorbable plate group healed with a mean 4.52-degree kyphosis, whereas patients in the titanium plate group healed with a mean 2.41-degree lordosis (P < 0.001). Conclusion: This report describes, to our knowledge, the first series of patients to undergo ACDF with the first commercially available resorbable cervical plate. Healing in kyphosis and pseudarthrosis was significantly more likely with resorbable implants as compared with the use of titanium plating. Although ultimate clinical outcomes were good, x-ray outcomes may be better with the use of titanium plating.

Audio Stories as Incidental Language Teachers

2020 ◽  
pp. 1-12 ◽  
Author(s):  
Ute Ritterfeld ◽  
Timo Lüke
Keyword(s):  
Language Learning ◽  
Low Socioeconomic Status ◽  
Language Teachers ◽  
Control Group ◽  
Low Socioeconomic ◽  
Migrant Families ◽  
Populations At Risk ◽  
Grammatical Skills ◽  
Entertainment Value

Abstract. Audio stories offer a unique blend of narrative entertainment with language learning opportunities as a user’s enjoyment is dependent on their processing of the linguistic content. A total of 138 third- and fourth-graders from low socioeconomic status and migrant families recruited from a metropolitan area in Germany participated in a randomized pre–post follow-up intervention study with a control group. Children listened to a tailored crime story of approximately 90 min over a period of 3 days within the classroom setting. Entertainment value for the age group was established in a pilot study. Outcome variables included semantic and grammatical skills in German and were administered before (pretest), shortly after intervention (posttest), and 2 weeks later (follow-up). We used nonverbal intelligence, reading, comprehension skills, age and sex as control variables. Results indicate a strong positive effect of media reception on language skills. The effectiveness of the intervention is discussed with reference to different linguistic domains, entertainment value, and compensatory effects in populations at risk of language learning deficits.

Computed Tomography-Based Patient-Specific Instrumentation Loses Accuracy with Significant Varus Preoperative Misalignment

2020 ◽  
Author(s):  
Vicente Jesús León-Muñoz ◽  
Mirian López-López ◽  
Alonso José Lisón-Almagro ◽  
Francisco Martínez-Martínez ◽  
Fernando Santonja-Medina
Keyword(s):  
Computed Tomography ◽  
Deformity Correction ◽  
Patient Specific ◽  
Control Group ◽  
X Rays ◽  
Varus Alignment ◽  
Patient Specific Instrumentation ◽  
Conventional Instrumentation ◽  
The Mean ◽  
Valgus Alignment

AbstractPatient-specific instrumentation (PSI) has been introduced to simplify and make total knee arthroplasty (TKA) surgery more precise, effective, and efficient. We performed this study to determine whether the postoperative coronal alignment is related to preoperative deformity when computed tomography (CT)-based PSI is used for TKA surgery, and how the PSI approach compares with deformity correction obtained with conventional instrumentation. We analyzed pre-and post-operative full length standing hip-knee-ankle (HKA) X-rays of the lower limb in both groups using a convention > 180 degrees for valgus alignment and < 180 degrees for varus alignment. For the PSI group, the mean (± SD) pre-operative HKA angle was 172.09 degrees varus (± 6.69 degrees) with a maximum varus alignment of 21.5 degrees (HKA 158.5) and a maximum valgus alignment of 14.0 degrees. The mean post-operative HKA was 179.43 degrees varus (± 2.32 degrees) with a maximum varus alignment of seven degrees and a maximum valgus alignment of six degrees. There has been a weak correlation among the values of the pre- and postoperative HKA angle. The adjusted odds ratio (aOR) of postoperative alignment outside the range of 180 ± 3 degrees was significantly higher with a preoperative varus misalignment of 15 degrees or more (aOR: 4.18; 95% confidence interval: 1.35–12.96; p = 0.013). In the control group (conventional instrumentation), this loss of accuracy occurs with preoperative misalignment of 10 degrees. Preoperative misalignment below 15 degrees appears to present minimal influence on postoperative alignment when a CT-based PSI system is used. The CT-based PSI tends to lose accuracy with preoperative varus misalignment over 15 degrees.

The effectiveness of positive training on happiness, aggression and hope in adolescents with leukemia in Ahvaz

2018 ◽  
Vol 9 (01) ◽  
Author(s):  
Marzieh . Shamkhani ◽  
Ali . Khalafi
Keyword(s):  
Sampling Method ◽  
Analysis Of Covariance ◽  
Control Group ◽  
Positive Attitudes ◽  
Measurement Tools ◽  
Post Test ◽  
Aggression Questionnaire ◽  
Experimental Group ◽  
Period Measurement

The purpose of this study was to determine the effectiveness of positive learning on happiness, Aggression and hope for adolescents with leukemia in Ahvaz. The sample consisted of 30 people who were selected by available sampling method. 15 subjects in the experimental group and 15 in the control group were randomly assigned. The experimental design was a pre-test-post-test type with control group and follow-up period. Measurement tools included Oxford Happiness Inventory (Argyle, 1989); Ahwaz's Aggression Questionnaire (Zahedifar, Najarian, and Shokrkon, 2000); Hope Scale (Schneider, 1991). To run, at first, the pre-test was taken from both groups. Then, the experimental group was trained in 14 sessions of 90 minutes, and after each group, they were subjected to post-test. And one month later, the follow-up process was completed. Data analysis was performed using multivariate covariance analysis (MANCOVA) and one-way analysis of covariance (ANCOVA). The results showed that positive attitudes toward happiness, aggressiveness and hopefulness of adolescents with leukemia in Ahvaz were effective.

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