scholarly journals IMPROVEMENT OF ODI AND SF-36 QUESTIONNAIRES SCORE AFTER ONE YEAR OF PLIF OR TLIF

2019 ◽  
Vol 18 (4) ◽  
pp. 318-321
Author(s):  
Fabiano Caumo ◽  
Carlos Henrique Maçaneiro ◽  
Ricardo Kiyoshi Miyamoto ◽  
Rodrigo Fetter Lauffer ◽  
Ricardo André Acácio dos Santos
Keyword(s):  
Hospital Stay ◽  
Randomized Study ◽  
Health State ◽  
Single Center ◽  
Level Of Evidence ◽  
Sf 36 ◽  
The Mean ◽  
Group 2 ◽  
One Year ◽  
The One

ABSTRACT Objective: Determine if patients undergoing PLIF or TLIF surgery achieved improvement in the score of ODI and SF-36 questionnaires one year after surgery. Methods: Retrospective, single-center and non-randomized study. Patients submitted to spinal surgery using the PLIF or TLIF technique were included who completed the ODI and SF-36 questionnaires at least at the preoperative visit, and one year after surgery. Patients were divided into two groups, Group 1 (1 surgery level) and Group 2 (> 1 surgery level) and the ODI and SF-36 scores were compared for improvement. Results: The mean age was 47 years, with 52% of males (13/25) and mean of 5 days of hospital stay. Patients presented a significant improvement of ODI questionnaire (p<0.001) and in all SF-36 domains except in General Health State (p=0.58). In each group, it was observed that patients submitted to more than one level of surgery had greater blood loss and shorter hospital stay; however, the improvement obtained in ODI and SF-36 compared to the one-level surgery group was similar. Conclusions: PLIF and TLIF techniques are effective and lead to improved scores in ODI and SF-36 questionnaires one year after surgery. Patients undergoing two or more levels of instrumentation showed significant and similar improvement in ODI and SF-36. Level of evidence II, Single-Center Retrospective Study.

scholarly journals Evaluation of Rib Fractures due to Trauma

2021 ◽  
pp. 46-50
Author(s):  
Suphi Aydin ◽  
Ahmet Dumanli ◽  
Adem Gencer
Keyword(s):  
Gastrointestinal Bleeding ◽  
Hospital Stay ◽  
Traffic Accidents ◽  
Length Of Hospital Stay ◽  
Mortality Rates ◽  
Rib Fractures ◽  
The Mean ◽  
One Year ◽  
The One

Introduction and Aim: We aimed to evaluate the one-year mortality rates and the effect of comorbid diseases on mortality in patients with trauma and isolated rib fractures. Materials and Methods: Ninety patients who had trauma, isolated rib fracture between January 2016 and December 2016 and could be reached after one year after the trauma were included in the study. The files of the patients were scanned retrospectively. Age, gender, and length of hospital stay were recorded. After one-year follow-up, they were contacted by phone to evaluate the rates of additional disease and mortality. Results: 27 of the patients were female (30%), 63 of them were male (70%). Regarding the causes of injury, there were falls in 42 patients at most and in-vehicle traffic accidents in 35 patients. The mean age was 56.85 ± 16.33, the mean hospital stay was 4.04 ± 4.55 days. The most common comorbidities were diabetes mellitus in 13 patients and hypertension in 11 patients. The least detected additional diseases are; Ulcerative colitis, epilepsy, arrhythmia, gastroesophageal reflux, gastrointestinal bleeding, rheumatism, Alzheimer and Familial Mediterranean Fever in 1 patient each. One patient died who had gastrointestinal bleeding. Mortality rate was 1.11%. Conclusions: Post-traumatic rib fractures disrupt people's quality of life and cause morbidity and mortality. Although the risk of comorbid mortality increases, close follow-up is important in preventing or reducing mortality rates.

Association of Visual Appearance on Outcomes After Hallux Valgus Surgery

2021 ◽  
pp. 107110072110199
Author(s):  
Hakan Bahar ◽  
Kadir Ilker Yildiz
Keyword(s):  
Hallux Valgus ◽  
Short Form ◽  
Functional Improvement ◽  
Level Of Evidence ◽  
Visual Appearance ◽  
Chevron Osteotomy ◽  
Sf 36 ◽  
Functional Scores ◽  
Group 2 ◽  
Group 1

Background: In this study, our aim was to determine the effect of cosmetic improvement on patient satisfaction and functional scores in hallux valgus (HV) surgery. Methods: Preoperative foot photographs of 105 patients who had undergone chevron osteotomy for HV between 2016 and 2018 were taken. The patients were divided into 2 groups. Twenty-four months after surgery, the preoperative foot photographs were shown to patients in group 1 (n = 52) but not to patients in group 2 (n = 53). The groups were then compared using the visual analog scale (VAS), the American Orthopaedic Foot & Ankle Society Hallux Metatarsophalangeal-Interphalangeal (AOFAS Hallux MTP-IP), and the 36-Item Short Form Health Survey (SF-36) scores. Both groups were evaluated radiologically with preoperative and postoperative hallux valgus angles and intermetatarsal angles. Results: There was no difference between the 2 groups in terms of radiologic parameters either pre- or postoperatively, or AOFAS Hallux MTP-IP scores postoperatively. However, for group 1, the VAS was lower (0.4±0.8 vs 1.8±1.6, P = .003) and both the SF-36 physical functioning (88.3±18.1 vs 79.1±23.2, P = .017) and SF-36 mental health scores were higher (78.8±19 vs 69.2±16.3, P = .022). Conclusion: Visualizing improvement in the cosmetic appearance of the foot appears associated with patients’ perception of subjective pain and functional improvement. We recommend that preoperative foot photographs be taken and recorded. Level of Evidence: Level III, case-control study.

scholarly journals Outcomes of coaxial microincision cataract surgery versus conventional phacoemulsification surgery

2019 ◽  
Vol 16 (3) ◽  
pp. 168-178
Author(s):  
Anu Malik ◽  
Smruti Ranjan Dethi ◽  
Yogesh Kumar Gupta ◽  
Alka Gupta
Keyword(s):  
Cataract Surgery ◽  
Randomized Study ◽  
Corrected Visual Acuity ◽  
Age Related ◽  
Significant Difference ◽  
Induced Astigmatism ◽  
The Mean ◽  
Group 2 ◽  
Surgically Induced ◽  
Group 1

Aim: To compare surgical parameters and visual outcomes of coaxial microincision cataract surgery (MICS) with standard phacoemulsification. Methods: A prospective randomized study was conducted on 60 eyes of 60 patients with age-related uncomplicated cataract who underwent: standard phacoemulsification surgery (30 eyes) i.e., Group 1, or coaxial MICS (30 eyes) i.e., Group 2. Intraoperative parameters were mean effective phacoemulsification power (EPP), effective phacoemulsification time (EPT), and total volume of balanced salt solution (BSS) used. Best-corrected visual acuity (BCVA) and surgically induced astigmatism (SIA) were evaluated pre- and postoperatively. Results: Mean BCVA at 6 weeks was 0.04 ± 0.07 in Group 1 and 0.05 ± 0.08 in Group 2. No significant difference was observed in SIA between the two groups. Mean EPT was 29.80 ± 3.67 seconds in Group 1 and 31.93 ± 4.08 seconds in Group 2. The mean total EPP in Group 1 was 35.77 ± 5.17%, whereas it was 33.70 ± 3.05% in Group 2. There was a significant statistical difference between mean EPP and EPT in the two groups. Mean total BSS volume used in Group 1 was 128.83 ± 19.81 ml, whereas it was 139.33 ± 13.57 ml in Group 2. Conclusion: Although EPT and BSS volume used were significantly higher in coaxial MICS, the postoperative results of the two techniques were comparable.

scholarly journals ANALGESIC EFFICACY OF EPIDURAL MORPHINE AND CLONIDINEIN PATIENTS UNDERGOING DECOMPRESSION OF THE LUMBAR CANAL: A PROSPECTIVE RANDOMIZED TRIAL

2017 ◽  
Vol 16 (3) ◽  
pp. 188-192
Author(s):  
BRUNO RONCAGLIO ◽  
RAPHAEL FERNANDES CALHAU ◽  
CHARBEL JACOB JÚNIOR ◽  
IGOR MACHADO CARDOSO ◽  
JOSÉ LUCAS BATISTA JÚNIOR ◽  
...  
Keyword(s):  
Epidural Morphine ◽  
Randomized Study ◽  
Analgesic Efficacy ◽  
Control Group ◽  
Lumbar Arthrodesis ◽  
The Mean ◽  
Group 2 ◽  
Student’S T ◽  
Microsoft Office ◽  
Student’S T Test

ABSTRACT Objective: To evaluate the postoperative analgesic efficacy in patients undergoing lumbar canal decompression using epidural morphine and clonidine at the Hospital Santa Casa de Vitória - ES, Brazil. Methods: Prospective, randomized study of 60 patients with stenosis of the lumbar canal up to two levels with surgical indication, in which decompression of the canal was performed in association with lumbar arthrodesis. In group 1 we performed conventional postoperative analgesia and in group 2, in addition to conventional analgesia, we associated epidural morphine and clonidine. We used VAS as a means of analyzing pain intensity at 1, 12, and 36 hours after surgery. The statistical analysis was performed using Microsoft Office/Excel and the software GraphPad Prism (San Diego, CA, USA). Results: The mean age of patients was 47 years, and 52% were female. The mean VAS in the first hour, 12th, and 36th hours after surgery in the control group was 5.44, 2.13, and 0.55 respectively. In the morphine-clonidine group it was 6.96; 2.21 and 0.60. Comparing one group with another in its absolute values through the Mann-Whitney test, as well as comparing the pain variations between the 1st and 12th hour (1h X 12h) and between the 12th hour and 36th hour (12h x 36h ) through Student’s t test it became clear that there was no statistical difference between groups (p > 0.05). Conclusions: The addition of epidural morphine and clonidine to conventional analgesia is not beneficial to reduce postoperative pain in patients undergoing lumbar canal decompression.

scholarly journals Pulsed Radiofrequency for Chronic Inguinal Neuralgia

2015 ◽  
Vol 2;18 (2;3) ◽  
pp. E147-E155
Author(s):  
Yasser M. Amr
Keyword(s):  
Pain Relief ◽  
Nerve Root ◽  
Small Sample ◽  
Pulsed Radiofrequency ◽  
Group 2 ◽  
One Year ◽  
The One ◽  
Inguinal Neuralgia ◽  
Group 1

Background: Chronic inguinal neuralgia has been reported after inguinal herniorrhaphy, caesarean section, appendectomy, and trauma to the lower quadrant of the abdomen or inguinal region. Objectives: This study was designed to evaluate the efficacy of pulsed radiofrequency in management of chronic inguinal neuralgia. Study Design: Randomized, double-blind controlled trial. Setting: Hospital outpatient setting. Methods: Twenty-one patients were allocated into 2 groups. Group 1 received 2 cycles of pulsed radiofrequency (PRF) for each nerve root. In Group 2, after stimulation, we spent the same time to mimic PRF. Both groups received bupivacaine 0.25% + 4 mg dexamethasone in 2 mL for each nerve root. Visual Analogue Scale (VAS) was assessed. Duration of the first block effective pain relief was reported. Repeated PRF blockade was allowed for any patient who reported a VAS > 30 mm in both groups during the one year follow-up period. The number and duration of blocks were reported and adverse effects were also reported. Results: Significantly longer duration of pain relief was noticed in Group 1 (P = 0.005) after the first block, while the durations of pain relief of the second block were comparable (P = 0.59). In Group 1 the second PRF produced pain relief from the twenty-fourth week until the tenth month while in Group 2, pain relief was reported from the sixteenth week until the eighth month after the use of PRF. All patients in Group 2 received 3 blocks (the first was a sham PRF) during the one year follow-up period. Meanwhile, 2 PRF blocks were sufficient to achieve pain relief for patients in Group 1 except 4 patients who needed a third PRF block. No adverse events were reported. Limitations: Small sample size. Conclusion: For intractable chronic inguinal pain, PRF for the dorsal root ganglion represents a promising treatment modality. Key words: Radiofrequency, chronic, inguinal neuralgia

scholarly journals Factors that affect the one-year mortality rate after lower limb amputation in the Hong Kong Chinese population

2021 ◽  
Vol 28 ◽  
pp. 221049172110569
Author(s):  
Pui M Chung ◽  
Bolton KH Chau ◽  
Esther C-S Chow ◽  
Kwok H Lam ◽  
Nang MR Wong
Keyword(s):  
Mortality Rate ◽  
Lower Limb ◽  
Chinese Population ◽  
Major Amputation ◽  
Lower Limb Amputation ◽  
Hong Kong Chinese ◽  
Limb Amputation ◽  
The Mean ◽  
One Year ◽  
The One

Introduction Lower limb amputation has significant morbidity and mortality. This study reviews the potential factors affecting the one-year mortality rate after lower limb amputation in the Hong Kong Chinese population. Methods Cases with lower limb amputations (toe, ray, below-knee, and above-knee amputations) from a regional hospital from January 2016 to December 2017 were recruited. Amputations due to trauma were excluded. The one-year mortality rate and the potential risk factors (age, sex, length-of-stay, multiple operations, extent of surgery (minor vs. major), medical comorbidities including (1) end-stage renal failure (ESRF), (2) cardiac diseases, (3) ischemic heart disease, (4) peripheral vascular disease and (5) diabetes mellitus) were analyzed by multiple logistic regression using Matlab 2018a. Results A total of 132 patients were recruited (173 operations). The one-year mortality rate was 36.3%. The mean age at death was 72.2 years. The results of the regression analysis showed patients having ESRF (β = 2.195, t 120 = 3.008, p = 0.003) or a major amputation (including above- or below-knee amputation) (β = 1.079, t 120 = 2.120, p = 0.034), had a significantly higher one-year mortality. The remaining factors showed no significant effect. The one-year mortality rate in ESRF patients was 77.8%; while the one-year mortality rate without ESRF was 29.8%. The mean age at death in the ESRF group was 62.9 years; while that without ESRF was 76.1 years. The one-year mortality for patients with major amputation was 45.8% while that for minor amputation was 20.4%. Conclusion ESRF and major amputation are factors that increase the one-year mortality rate after lower limb amputation.

scholarly journals COMPARISON OF A NEW VERESS NEEDLE ENTRY METHOD AND CLASSIC VERESS NEEDLE ENTRY METHOD IN GYNECOLOGIC LAPAROSCOPY: A PROSPECTIVE RANDOMIZED STUDY

2018 ◽  
Vol 6 (2) ◽  
pp. 74-79
Author(s):  
Uğurkan Erkayıran ◽  
Bülent Köstü ◽  
Alev Özer
Keyword(s):  
Horizontal Plane ◽  
Randomized Study ◽  
Veress Needle ◽  
Operative Outcomes ◽  
Laparoscopic Entry ◽  
Gynecologic Laparoscopy ◽  
The Mean ◽  
Group 2 ◽  
Needle Entry ◽  
Group 1

Background: To compare cranial 15º angulation of Veres needle to classic Veress needle entry in closed laparoscopic entry in obese patients. Method: Patients with BMI index>30 were divided into two groups. Initial entry into the abdomen in Group 1 (n=29) was performed with the intraumbilical insertion of Veress needle in 90o angle relative to the horizontal plane. In Group 2 (n=31) the Veress needle was placed intraumbilically in a cranial direction, the tip of the needle towards the thoracic cavity, with an angle of 15o to the horizontal plane. Two groups were compared with respect of the operative outcomes. Results: In Group 2, the mean number of Veress needle entries attempt was significantly lower than Group 1 (p=0.01). Time to insertion of the Veress needle was found to be significantly shorter in Group 2 than in Group 1 (p<0.001). While entry failure occurred in 3 patients in Group 1 (10.3%), no failures were monitored in any patients in Group 2 (p= 0.01). Complication rate was significantly lower in Group 2 than in Group 1 (p= 0.03). Conclusion: Placement of Veress needle intraumbilically in a cranial direction at 15°angle to the horizontal plane increases entry success and reduces complications.

482Direct oral anticoagulant rivaroxaban in very old and frail patients: A one-year prospective follow-up of a large-scale cohort (SAFIR-AC)

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
O Hanon ◽  
J Vidal ◽  
E Chaussade ◽  
J P David ◽  
N Boulloche ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Major Bleeding ◽  
Large Scale ◽  
Bleeding Risk ◽  
Geriatric Population ◽  
Very Old ◽  
The Mean ◽  
One Year ◽  
The One

Abstract Background/Introduction Age is one of the strongest predictors/risk factors for ischemic stroke in subjects with atrial fibrillation (AF). Direct oral anticoagulants (DOACs) have been shown to be effective in the prevention of this condition; however, clinical evidence on bleeding risk with this therapeutic strategy in very old and frail geriatric patients is poor. Purpose To assess bleeding risk in French geriatric patients aged ≥80 years and diagnosed with AF newly treated with rivaroxaban. Methods Subjects, presenting to one of 33 geriatric centers, with non-valvular AF and recent initiation of a treatment with rivaroxaban were enrolled in the study and followed-up every 3 months for 12 months. Clinical and routine laboratory data and evaluation scores, such as HAS-BLED, HEMORR2HAGES, ATRIA, and CHA2DS2-VASc, as well as comprehensive geriatric evaluation were reported. Major bleeding, as defined in ROCKET AF study, was reported at each visit, and this primary outcome was adjudicated by an independent committee. Results of this cohort were compared with findings from a similar cohort treated with vitamin K antagonists (VKAs) from the same centers (n=924). Results A total of 1045 subjects were enrolled in the study of whom 995 (95%) had a one-year follow-up (analyzed population). The mean (standard deviation (SD)) age was 86.0 (4.3) years, with the majority of patients being female (61%), 23% aged 90 years or older, and 48% having an estimated glomerular filtration rate (eGFR) <50 mL/min. The main comorbidities were hypertension in 77% of subjects, malnutrition 49%, anemia 43%, dementia 39%, heart failure 36%, and falls 27%. The mean (SD) score for CHA2DS2-VASc was 4.8 (1.4), HAS-BLED 2.4 (0.9), Mini-Mental State Examination (MMSE) 21.5 (6.9), Activities of Daily Living (ADL) 4.4 (1.9), and Charlson Comorbidity Index 6.7 (2.0). The one-year rate of major bleeding events was 6.4% of which 0.8% were fatal and 1.1% intracranial hemorrhages (ICH), whereas the one-year rate of ischemic stroke was 1.4% and all-cause mortality 17.9%. Computed with VKA cohort findings and adjusted for age, gender, eGFR and Charlson score, this would result in a hazard ratio of 0.54 (95% confidence interval [CI], 0.38 to 0.78) for major bleeding, 0.36 (0.17 to 0.76) for ICH, 0.62 (0.29 to 1.33) for ischemic stroke, and 0.82 (0.65 to 1.02) for all-cause mortality, in favor of rivaroxaban. Conclusions This is the first large-scale prospective study in geriatric population in AF subjects treated with DOAC (rivaroxaban) Major bleeding risk appeared higher in very old than younger population, however major bleeding and ICH rates were significantly lower with rivaroxaban than with VKAs when used in the same geriatric population. This study indicates that Rivaroxaban can be used in very old and frail patients for the treatment of non-valvular AF. Acknowledgement/Funding Unrestricted grant from Bayer

scholarly journals Meniscus Repair Outcomes with and without Bone Marrow Aspiration Concentrate

2019 ◽  
Vol 7 (7_suppl5) ◽  
pp. 2325967119S0028 ◽  
Author(s):  
Patrick Allan Massey ◽  
Andrew Zhang ◽  
Christine Bayt Stairs ◽  
Stephen Hoge ◽  
Trevor Carroll ◽  
...  
Keyword(s):  
Bone Marrow ◽  
Bone Marrow Aspiration ◽  
Meniscus Repair ◽  
Control Group ◽  
Pain Level ◽  
Average Pain ◽  
The Mean ◽  
One Year ◽  
The One

Objectives: The purpose of the current study is to review the results of meniscus repairs with and without bone marrow aspiration concentrate (BMAC). It is hypothesized that with BMAC, meniscus repair outcomes will be improved when compared to without BMAC at 1 year after surgery. Methods: This is a prospective case control study performed from August 2014 until August 2017. Patients were included if they had a meniscus repair performed with no history of prior meniscus surgery to the operative knee. Patients were excluded if there was a full thickness cartilage tear or International Cartilage Repair Society (ICRS) Grade IV cartilage tear not treated in a single staged surgery. Patients were also excluded if they did not reach the one year follow-up, had a multi-ligamentous knee injury requiring multiple staged procedures. From August 2014 until November 2015, patients had meniscus repair without BMA. Menisci were all repaired arthroscopically using inside-out, outside-in and all-inside techniques. After November 2015, all meniscus repairs were augmented with BMAC. In the BMAC group, all bone marrow was obtained from the ipsilateral femur during the time of surgery. The Biocue BMAC system (Zimmer Biomet, Warsaw Indiana) was used for bone marrow aspiration and BMAC was injected directly into the tear site after repair. Numerical data such as VAS, lysholm and IKDC was analyzed using a 2 sample T-test. Categorical data such as sex, tear location, type of tear and zone of tear were analyzed using a chi-square. Results: A total of 150 patients were initially included in the study. The average age in the control group was 26.3 versus 29.4 in the BMAC group (P=0.27). Thirty seven percent of the control group had an ACL reconstruction versus 40% in the BMAC group (P= .77). The control group improved from an average pain level of 6.1 to 1.2 and the BMAC group improved from an average pain level of 5.9 to 0.7 at the 1 year end point. Both the control group and BMAC group improved with respect to pain with no difference at the 1 year end point (P=.19). There was, however a significantly larger reduction in pain at the 6 week and 3 month time point with BMAC compared to the control group (P=.02 and P=.02 respectively). At the 1-year follow-up, the mean lysholm score improved from 43 to 92 in the control group and 43 to 90 in the BMAC group. The mean IKDC score improved from 37 to 87 in the control group and 36 to 83 in the BMAC group at the one year follow-up. Conclusion: Meniscus repair outcomes were improved at 6 weeks and 3 months post-operatively, when BMAC is used to augment meniscus repair compared to repair without BMAC. Both groups, control group and BMAC meniscus repair group had improved outcomes at 1 year post-operatively with respect to VAS, lysholm and IKDC, with no difference in complication rate.

Long-term outcome and prognostic factors of posterior circulation ischemia patients: Results from a single center retrospective study

Vascular ◽  
2019 ◽  
Vol 28 (1) ◽  
pp. 25-30
Author(s):  
Yanfei Han ◽  
Man Xu ◽  
Yuan Zhao ◽  
Yongbo Zhang
Keyword(s):  
Prognostic Factors ◽  
Basilar Artery ◽  
Good Prognosis ◽  
Posterior Circulation ◽  
National Institutes Of Health ◽  
Long Term Outcome ◽  
Nihss Score ◽  
The Mean ◽  
One Year ◽  
The One

Objective This study was to assess the clinical features and prognostic factors of posterior circulation cerebral infarction (PCCI) patients. Methods A total of 165 PCCI patients who were admitted to the Department of Neurology, Beijing Friendship hospital, Capital Medical University between January 2016 and December 2016 were included. Patients had complete medical record and received 12-month follow-up. The demographics, risk factors, clinical manifestations, National Institutes of Health Stroke Scale (NIHSS) score and imaging findings were collected and factors affecting their prognosis were further analyzed. Results The mean age was 59.5 ± 10.8 years and the mean National Institutes of Health Stroke Scale (NIHSS) score on admission was 6.6 ± 2.8. The one-year recurrence rate of stroke was 6.7%; 84.8% of patients had good prognosis (modified Rankin Scale [mRS] score 0–3) and 15.2% had poor prognosis (mRS score >3). The one-year mortality was 3.0%. Patients with ≥50% stenosis in the basilar artery and higher NIHSS score were more likely to have poor outcome. Conclusion The majority of PCCI patients have a good prognosis and a low mortality. The prognosis is poor in patients with ≥50% stenosis in the basilar artery and higher NIHSS score on admission.

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