scholarly journals Trends in slipped capital femoral epiphysis: is the rate declining?

2018 ◽  
Vol 12 (5) ◽  
pp. 428-433 ◽  
Author(s):  
I. M. Gutman ◽  
S. R. Gilbert
Keyword(s):  
Slipped Capital Femoral Epiphysis ◽  
Temporal Analysis ◽  
Operative Approach ◽  
Comparison Study ◽  
Level Of Evidence ◽  
Patient Demographics ◽  
Retrospective Comparison ◽  
Nationally Representative ◽  
Inpatient Database ◽  
Haenszel Test

Purpose Slipped capital femoral epiphysis (SCFE) is an adolescent hip condition with a high risk of complication. The purpose of this study was to evaluate trends in treatment using a prospectively collected paediatric nationally representative database. Methods A total of 9034 patients undergoing treatment for idiopathic SCFE were selected by querying the Healthcare Cost and Utilization Project’s Kids’ Inpatient Database for the years 1997, 2000, 2003, 2006, 2009 and 2012. The selected patients were separated based on operative approach and these cohorts were analyzed based on temporal and categorical differences in operative approach, patient demographics and clinical characteristics. Univariate and multivariate analyses were used when appropriate and the Mantel-Haenszel test for trend was used in temporal analysis. Results Overall SCFE procedures have decreased 27.5% (p < 0.001). Closed procedures have decreased 28.5% (p < 0.001), while open procedures have decreased 44.8% (p < 0.001). Bilateral closed procedures have increased 7.2% (p < 0.001). The ratio of open to closed procedures decreased in patients aged nine to 12 years and increased in patients aged 13 to 16 years (p < 0.001). Conclusion Here we report age stratified trends in treatment for idiopathic SCFE using nationally representative data and show an overall decrease in admissions and procedures over time. Level of Evidence Level III, retrospective comparison study

scholarly journals Association of HIV infection with age and symptomatic carotid atherosclerotic disease at the time of carotid intervention in the United States

2018 ◽  
Vol 23 (5) ◽  
pp. 467-475 ◽  
Author(s):  
Timothy C Lin ◽  
Brittany N Burton ◽  
Andrew Barleben ◽  
Martin Hoenigl ◽  
Rodney A Gabriel
Keyword(s):  
United States ◽  
Hiv Infection ◽  
The United States ◽  
Atherosclerotic Disease ◽  
Symptomatic Carotid ◽  
Patient Demographics ◽  
Younger Age ◽  
Male Sex ◽  
Nationally Representative ◽  
Inpatient Database

The primary objectives of this work were: (1) to describe trends in HIV prevalence among those undergoing carotid intervention (carotid endarterectomy or carotid artery stenting) in the United States; and (2) to determine if HIV infection is independently associated with symptomatic carotid atherosclerotic disease or age at the time of carotid intervention. In a nationally representative inpatient database from 2004 to 2014, HIV infection was associated with younger age at the time of carotid intervention (59 years [SE 0.2] vs 71 years [SE 0.01], p < 0.001), male sex (83% vs 58%, p < 0.001), black race (21% vs 4%, p < 0.001), and symptomatic carotid atherosclerotic disease (18.8% vs 11.0%, p < 0.001). Among those undergoing carotid intervention, there was a significant increase in the prevalence of HIV from 0.08% in 2004 to 0.17% in 2014 ( p < 0.001). After adjustment for patient demographics, comorbidities and other covariates, HIV infection remained significantly associated with younger age (–8.9 years; 95% CI: –9.7 to −8.1; p < 0.001) at the time of carotid intervention, but HIV infection was not independently associated with symptomatic carotid atherosclerotic disease.

scholarly journals Trauma resource pit stop: increasing efficiency in the evaluation of lower severity trauma patients

2021 ◽  
Vol 6 (1) ◽  
pp. e000670
Author(s):  
Imad S Dandan ◽  
Gail T Tominaga ◽  
Frank Z Zhao ◽  
Kathryn B Schaffer ◽  
Fady S Nasrallah ◽  
...  
Keyword(s):  
Injury Severity ◽  
Diagnostic Testing ◽  
Trauma Team ◽  
Hospital Length ◽  
Hospital Length Of Stay ◽  
Trauma Patients ◽  
Level Of Evidence ◽  
Evaluation Time ◽  
Retrospective Comparison ◽  
Trauma Bay

BackgroundOvertriage of trauma patients is unavoidable and requires effective use of hospital resources. A ‘pit stop’ (PS) was added to our lowest tier trauma resource (TR) triage protocol where the patient stops in the trauma bay for immediate evaluation by the emergency department (ED) physician and trauma nursing. We hypothesized this would allow for faster diagnostic testing and disposition while decreasing cost.MethodsWe performed a before/after retrospective comparison after PS implementation. Patients not meeting trauma activation (TA) criteria but requiring trauma center evaluation were assigned as a TR for an expedited PS evaluation. A board-certified ED physician and trauma/ED nurse performed an immediate assessment in the trauma bay followed by performance of diagnostic studies. Trauma surgeons were readily available in case of upgrade to TA. We compared patient demographics, Injury Severity Score, time to physician evaluation, time to CT scan, hospital length of stay, and in-hospital mortality. Comparisons were made using 95% CI for variance and SD and unpaired t-tests for two-tailed p values, with statistical difference, p<0.05.ResultsThere were 994 TAs and 474 TRs in the first 9 months after implementation. TR’s preanalysis versus postanalysis of the TR group shows similar mean door to physician evaluation times (6.9 vs. 8.6 minutes, p=0.1084). Mean door to CT time significantly decreased (67.7 vs. 50 minutes, p<0.001). 346 (73%) TR patients were discharged from ED; 2 (0.4%) were upgraded on arrival. When admitted, TR patients were older (61.4 vs. 47.2 years, p<0.0001) and more often involved in a same-level fall (59.5% vs. 20.1%, p<0.0001). Undertriage was calculated using the Cribari matrix at 3.2%.DiscussionPS implementation allowed for faster door to CT time for trauma patients not meeting activation criteria without mobilizing trauma team resources. This approach is safe, feasible, and simultaneously decreases hospital cost while improving allocation of trauma team resources.Level of evidenceLevel II, economic/decision therapeutic/care management study.

Laparoscopic versus open transverse‐incision right hemicolectomy: a retrospective comparison study

2019 ◽  
Vol 89 (7-8) ◽  
Author(s):  
Claudio F. Feo ◽  
Carlo V. Feo ◽  
Alessandro Fancellu ◽  
Giorgio C. Ginesu ◽  
Giuseppe Cherchi ◽  
...  
Keyword(s):  
Right Hemicolectomy ◽  
Comparison Study ◽  
Transverse Incision ◽  
Retrospective Comparison

scholarly journals Regorafenib vs trifluridine/tipiracil for metastatic colorectal cancer refractory to standard chemotherapies: A multicenter retrospective comparison study in Japan

PLoS ONE ◽  
2020 ◽  
Vol 15 (6) ◽  
pp. e0234314
Author(s):  
Misato Ogata ◽  
Masahito Kotaka ◽  
Takatsugu Ogata ◽  
Yukimasa Hatachi ◽  
Hisateru Yasui ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Metastatic Colorectal Cancer ◽  
Comparison Study ◽  
Retrospective Comparison

scholarly journals Combined Imhauser osteotomy and osteochondroplasty in slipped capital femoral epiphysis through surgical hip dislocation approach

2020 ◽  
Vol 14 (3) ◽  
pp. 190-200 ◽  
Author(s):  
Mostafa M. Baraka ◽  
Hany M. Hefny ◽  
Mootaz F. Thakeb ◽  
Tamer A. Fayyad ◽  
Haytham Abdelazim ◽  
...  
Keyword(s):  
Slipped Capital Femoral Epiphysis ◽  
Alpha Angle ◽  
Hip Dislocation ◽  
Harris Hip Score ◽  
Functional Score ◽  
Surgical Hip Dislocation ◽  
Level Of Evidence ◽  
Surgical Dislocation ◽  
Imhauser Osteotomy ◽  
The Mean

Purpose Treatment of moderate to severe stable slipped capital femoral epiphysis (SCFE) remains a challenging problem. Open reduction by modified Dunn procedure carries a considerable risk of osteonecrosis (ON). Imhauser osteotomy is capable of realigning the deformity without the risk of ON, but the remaining metaphyseal bump is implicated with significant chondro-labral lesions and accelerated osteoarthritis. We conducted this study to evaluate the efficacy and safety of Imhauser osteotomy combined with osteochondroplasty (OCP) through the surgical hip dislocation (SHD) approach. Methods A prospective series of 23 patients with moderate-severe stable SCFE underwent Imhauser osteotomy and OCP through SHD. The mean age was 14.4 years (13 to 20) and the mean follow-up period was 45 months (24 to 66). The outcome measures included clinical and radiological parameters and Harris hip score (HHS) was used as a functional score. Results The mean HHS improved significantly from 65.39 to 93.3. The limb length discrepancy improved by a mean of 1.72 cm. The mean flexion and abduction arcs showed a significant improvement (mean increase of 37.5° and 18.5°, respectively). The mean internal rotation demonstrated the most significant improvement (mean increase of 38.5°). All the radiographic parameters improved significantly; including anterior and lateral slip angles (mean improvement 37.52° and 44.37°, respectively). The mean alpha angle decreased by 39.19°. The articulo-trochanteric distance significantly increased to a mean of 23.26 mm. No cases of ON or chondrolysis were identified. Conclusion Combined Imhauser osteotomy and OCP through the surgical dislocation approach provide a comprehensive and safe management of moderate to severe stable SCFE. Level of evidence IV

scholarly journals Lung ultrasonography versus chest CT in COVID-19 pneumonia: a two-centered retrospective comparison study from China

2020 ◽  
Vol 46 (9) ◽  
pp. 1761-1763 ◽  
Author(s):  
Yong Yang ◽  
Yi Huang ◽  
Feng Gao ◽  
Lijun Yuan ◽  
Zhen Wang
Keyword(s):  
Chest Ct ◽  
Lung Ultrasonography ◽  
Comparison Study ◽  
Retrospective Comparison
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