Prospective Investigation of the Relationship between Dorsal Tilt, Carpal Malalignment and Capitate Shift in Distal Radial Fractures

OrthoMedia ◽  
2021 ◽  
Keyword(s):  
Distal Radial Fractures ◽  
The Relationship ◽  
Prospective Investigation

Prospective investigation of the relationship between dorsal tilt, carpal malalignment, and capitate shift in distal radial fractures

2020 ◽  
Vol 102-B (1) ◽  
pp. 137-143
Author(s):  
Rachel Dias ◽  
Nick A. Johnson ◽  
Joseph J. Dias
Keyword(s):  
Operating Characteristic ◽  
Distal Radial Fracture ◽  
Radial Fracture ◽  
Roc Curve Analysis ◽  
Distal Radial Fractures ◽  
Initial Radiograph ◽  
Interval Linear ◽  
Adverse Influence ◽  
The Relationship ◽  
Prospective Investigation

Aims Carpal malalignment after a distal radial fracture occurs due to loss of volar tilt. Several studies have shown that this has an adverse influence on function. We aimed to investigate the magnitude of dorsal tilt that leads to carpal malalignment, whether reduction of dorsal tilt will correct carpal malalignment, and which measure of carpal malalignment is the most useful. Methods Radiographs of patients with a distal radial fracture were prospectively collected and reviewed. Measurements of carpal malalignment were recorded on the initial radiograph, the radiograph following reduction of the fracture, and after a further interval. Linear regression modelling was used to assess the relationship between dorsal tilt and carpal malalignment. Receiver operating characteristic (ROC) analysis was used to identify which values of dorsal tilt led to carpal malalignment. Results A total of 250 consecutive patients with 252 distal radial fractures were identified. All measures of carpal alignment were significantly associated with dorsal tilt at each timepoint. This relationship persisted after adjustment for age, sex, and the position of the wrist. Capitate shift consistently had the strongest relationship with dorsal tilt and was the only parameter that was not influenced by age or the position of the wrist. ROC curve analysis identified that abnormal capitate shift was seen with > 9° of dorsal tilt. Conclusion Carpal malalignment is related to dorsal tilt following a distal radial fracture. Reducing the fracture and improving dorsal tilt will reduce carpal malalignment. Capitate shift is easy to assess visually, unrelated to age and sex, and appears to be the most useful measure of carpal malalignment. The aim during reduction of a distal radial fracture should be to realign the capitate with the axis of the radius and prevent carpal malalignment. Cite this article: Bone Joint J 2020;102-B(1):137–143

Abstract 146: White Blood Cell Count and Risk of Stroke in Men and Women: the European Prospective Investigation into Cancer-Norfolk Prospective Population Study

Stroke ◽  
2012 ◽  
Vol 43 (suppl_1) ◽  
Author(s):  
Yangmei Li ◽  
Xinxue Liu ◽  
Robert N Luben ◽  
Amanda I Adler ◽  
Nicholas J Wareham ◽  
...  
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
Blood Cell ◽  
Systolic Blood Pressure ◽  
Men And Women ◽  
History Of ◽  
Wbc Count ◽  
The Relationship ◽  
Age And Sex ◽  
Prospective Investigation

Background and Objectives: An elevated white blood cell (WBC) count has been reported to be associated with all-cause mortality and risk of cardiovascular diseases. While the relationship between leukocyte count and coronary heart disease has been well documented, evidence on the association with risk of stroke has been less consistent. The aim of this study was to investigate the relationship between WBC count and incidence of stroke in a large cohort of disease-free men and women, and to assess how far any associations might be explained by traditional risk factors for stroke. Methods: We examined the prospective association between full blood WBC count and incident stroke in 7,392 men and 9,049 women from the general population participating in the European Prospective Investigation into Cancer-Norfolk Study. Participants were aged 39-79 years, without known heart attack, stroke, and cancer at the baseline examination in 1993-1997 and were followed up for incident stroke till March 2008. Results: During the median follow-up of 12 years, 542 incident stroke cases were observed. The age- and sex- adjusted risk of incident stroke increased with the increase of WBC count. Compared to the lowest quartile of WBC count, the age- and sex- adjusted hazard ratios (HRs) and 95% CIs for stroke were 1.11 (0.86-1.45), 1.40 (1.10-1.79), and 1.65 (1.29-2.09) in the second, third, and fourth quartile, respectively. Adjusting for smoking attenuated the results, while further adjustment for socioeconomic and lifestyle risk factors changed the association very little. The association was further attenuated after adjustment for biological risk factors such as systolic blood pressure and a history of diabetes at baseline, but people with the highest quartile of WBC count still had a higher risk of stroke than those in the lowest quartile (HR 1.32, 95% CI 1.02-1.71). Every 2*10 9 /L increase in WBC count was associated with a hazard ratio of 1.14 (95% CI 1.02-1.26) for stroke in the fully-adjusted model which included age, sex, smoking status, BMI, social class, educational level, alcohol intake, physical activity, systolic blood pressure, a history of diabetes at baseline, and total serum cholesterol. Conclusions: A positive association between WBC count and stroke was observed in these middle-aged and older men and women. Adjustment for smoking attenuated the association while multivariate adjustment for other risk factors did not further change the results.

Chronic Consumption of Artificial Sweetener in Packets or Tablets and Type 2 Diabetes Risk: Evidence from the E3N-European Prospective Investigation into Cancer and Nutrition Study

2017 ◽  
Vol 70 (1) ◽  
pp. 51-58 ◽  
Author(s):  
Guy Fagherazzi ◽  
Gaëlle Gusto ◽  
Aurélie Affret ◽  
Francesca Romana Mancini ◽  
Courtney Dow ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Metabolic Diseases ◽  
Artificial Sweeteners ◽  
Artificial Sweetener ◽  
Sweetened Beverages ◽  
Increased Risk ◽  
Nutrition Study ◽  
The Relationship ◽  
Prospective Investigation

Background: The influence of artificial sweeteners on metabolic diseases is controversial. Artificially sweetened beverages have been associated with an increased risk of type 2 diabetes (T2D) but biases and reverse causation have been suspected to have influenced the observed association. In addition, it has been suggested that investigation into the relationship between the frequency and duration of the consumption of packet or tablet artificial sweeteners and T2D risk is necessary. Methods: We used data from 61,440 women in the prospective E3N-European Prospective Investigation into Cancer and Nutrition study, conducted between 1993 and 2011. We estimated hazards ratios (HRs) and 95% CIs of T2D risk associated with both the frequency and the duration of use of artificial sweeteners consumed in packets or tablets. Results: Compared to “never or rare” consumers of artificial sweeteners, those using them “always or almost always” had an increased risk of T2D (HR = 1.83 [95% CI 1.66-2.02] in the multivariate model [MM], HR = 1.33 [95% CI 1.20-1.47] when further adjusted for body mass index, BMI). Women consuming artificial sweeteners in packets or tablets for more than 10 years also had an increased risk of T2D compared to never or rare users (HR = 2.10 [95% CI 1.83-2.40] in the MM and HR = 1.15 [95% CI 1.00-1.33] when adjusted for BMI, respectively). Conclusions: Our data suggest that both a higher frequency and a longer consumption of artificial sweeteners in packets or tablets was associated with T2D risk, independently of major T2D risk factors, but partially mediated by adiposity. A precautionary principle should be applied to the promotion of these products that are still largely recommended as healthy sugar substitutes.

The relationship between initial closed reduction and the surgical reconstruction of the radiocarpal joint line in distal radial fractures

Injury ◽  
2016 ◽  
Vol 47 (4) ◽  
pp. 925-929 ◽  
Author(s):  
P. Lechler ◽  
M. Börsch ◽  
N. Timmesfeld ◽  
T. Schwarting ◽  
C.K. Boese ◽  
...  
Keyword(s):  
Closed Reduction ◽  
Joint Line ◽  
Surgical Reconstruction ◽  
Distal Radial Fractures ◽  
Radiocarpal Joint ◽  
The Relationship

scholarly journals Interpretation Bias and Anxiety in Childhood: Stability, Specificity and Longitudinal Associations

2010 ◽  
Vol 39 (2) ◽  
pp. 191-204 ◽  
Author(s):  
Cathy Creswell ◽  
Thomas G. O'Connor
Keyword(s):  
Cognitive Processes ◽  
Community Sample ◽  
Anxiety Symptoms ◽  
Longitudinal Associations ◽  
One Year ◽  
The Stability ◽  
Anxiety Depression ◽  
The Relationship ◽  
Over Time ◽  
Prospective Investigation

Background: Biases in the interpretation of ambiguous material are central to cognitive models of anxiety; however, understanding of the association between interpretation and anxiety in childhood is limited. To address this, a prospective investigation of the stability and specificity of anxious cognitions and anxiety and the relationship between these factors was conducted. Method: Sixty-five children (10–11 years) from a community sample completed measures of self-reported anxiety, depression, and conduct problems, and responded to ambiguous stories at three time points over one-year. Results: Individual differences in biases in interpretation of ambiguity (specifically “anticipated distress” and “threat interpretation”) were stable over time. Furthermore, anticipated distress and threat interpretation were specifically associated with anxiety symptoms. Distress anticipation predicted change in anxiety symptoms over time. In contrast, anxiety scores predicted change in threat interpretation over time. Conclusions: The results suggest that different cognitive constructs may show different longitudinal links with anxiety. These preliminary findings extend research and theory on anxious cognitions and their link with anxiety in children, and suggest that these cognitive processes may be valuable targets for assessment and intervention.

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