Protocol for a systematic review of paediatric meniscal repair

2020 ◽  
Author(s):  
Dean Malik ◽  
Aadhar Sharma ◽  
Chinmay Gupte
Keyword(s):  
Treatment Options ◽  
Treatment Protocol ◽  
Meniscal Repair ◽  
Paediatric Population ◽  
Long Term Effects ◽  
Qualitative Synthesis ◽  
Anterior Cruciate Ligaments ◽  
Treatment Techniques ◽  
Anterior Cruciate

Abstract Background Meniscal tears in the paediatric population represent a significant challenge. Improved sensitivity of diagnostic imaging and increased intensity of organised sport among children is in part responsible for an increased incidence of injuries identified. While rare, these injuries have a significant impact on a patient’s future and necessitate timely and meticulous repair. Methods Adhering to PRISMA guidelines, MEDLINE, Embase and Cochrane databases will be interrogated from inception to November 2019. All primary clinical studies in which paediatric meniscal injuries are treated will be identified and included. Treatment techniques will be grouped according to surgical technique and a further analysis of any papers concomitantly repair anterior cruciate ligaments will also be analysed to identify any superiority. A qualitative synthesis will at first be attempted with further quantitative analysis should heterogeneity of studies allow it. Discussion Paediatric meniscal injuries provide a dilemma for even the most experience surgeon, with no consensus on a preferred treatment option. Outcomes are often poor and can have long-term effects with early onset of osteoarthritis and limitation of future function. As such, this review will be pivotal in identifying the different treatment options being employed for meniscal repair in a paediatric population, if there is any superiority in a given treatment choice and moving towards identified a standard treatment protocol.

The role of probiotics in correction of microbiocenosis and cytokine balance of the oral cavity of patient with chronic inflammatory disease of periodont

2020 ◽  
Vol 25 (4) ◽  
pp. 323-330
Author(s):  
E. S. Ovcharenko ◽  
V. V. Erichev ◽  
S. I. Risovannij ◽  
T. V. Aksenova ◽  
S. V. Melekhov ◽  
...  
Keyword(s):  
Oral Cavity ◽  
Periodontal Diseases ◽  
Treatment Protocol ◽  
Chronic Inflammatory Disease ◽  
Oral Microbiome ◽  
Comprehensive Treatment ◽  
Local Immunity ◽  
Treatment Techniques ◽  
Before And After

Relevance. A long-term inflammation in the oral cavity, unreasonable treatment of periodontal patients with antibiotics cause imbalance between certain types of fungal-bacterial associations accompanied by oral dysbiosis and change of local immune status. So, development and application of new comprehensive diagnosis and treatment techniques in periodontal patients, use of products for correction of microbiota and local immunity are a current and a long-term task. Purpose is to optimize the comprehensive treatment protocol of inflammatory periodontal diseases by introducing probiotics and evaluation of oral microbiome and cytokine profile.Materials and methods. 140 patients were examined. Of these 60 patients had chronic generalized plaque-induced gingivitis and 60 patients suffered from moderate chronic generalized periodontitis. Bacterial and fungal microbiome was assessed and the host immune response was evaluated in all patients before and after the treatment. Half of the patients were treated conventionally and the other half were treated according to a modified scheme: probiotic “Bifidumbacterin Forte” was added.Results. A large number of yeast-like fungi Candida and commensal bacteria were detected in periodontal pockets of patients with chronic generalized plaque-induced gingivitis and moderate chronic generalized periodontitis. That correlates with a significant increase of pro-inflammatory cytokines (TNF-α, IL—8), decrease of concentration of INF-γ and increase of antiinflammatory cytokine IL-4.Conclusion. Changes in clinical, microbiological and immunological values during a modified combination therapy with a probiotic and during a conventional treatment demonstrated that effectiveness of treatment of chronic gingivitis and chronic periodontitis increased by 40% and 37% respectively.

The Top 50 Most Cited Publications in Meniscus Research

2021 ◽  
Author(s):  
Kyle N. Kunze ◽  
Aidan Haddad ◽  
Alexander E. White ◽  
Matthew R. Cohn ◽  
Robert F. LaPrade ◽  
...  
Keyword(s):  
Sports Medicine ◽  
Citation Rate ◽  
Cross Sectional Study ◽  
Collective Knowledge ◽  
Cross Sectional ◽  
Anterior Cruciate Ligaments ◽  
Time Period ◽  
Wide Range ◽  
Anterior Cruciate

AbstractInjuries to the menisci of the knee are common in orthopedic sports medicine. Bibliometric studies can identify the core literature on a topic and help further our collective knowledge for both clinical and educational purposes. The purpose of the current study was to (1) identify and describe the 50 most cited articles in meniscus research over an 80-year time period to capture a wide range of influential articles and (2) identify the “citation classics” and milestone articles related to the meniscus of the knee. The Science Citation Index Expanded subsection of the Web of Science Core Collection was systematically searched for the 50 most cited meniscus articles. Data pertaining to bibliometric and publication characteristics were extracted and reported using descriptive statistics. The top 50 articles were published between the years 1941 and 2014 and collectively cited 13,152 times. The median (interquartile [IQR]) number of total citations per article was 203.5 (167.0–261.8), while the median citation rate was 9.6 (7.4–13.9) citations per year. The most cited article was “Knee joint changes after meniscectomy,” published in 1948. The article with the highest citation rate of 78.4 citations per year was “The long-term consequence of anterior cruciate ligaments and meniscus injuries – osteoarthritis,” published in 2007. The majority of articles were clinical outcome studies (n = 28, 56%). The top 50 most cited meniscus articles represent a compilation of highly influential articles which may augment reading curriculums and provide a strong knowledge base for orthopaedic surgery residents and fellows. The decade with the most articles was the 2000s, representing a recent acceleration in meniscus-based research. This is a level IV, cross-sectional study.

scholarly journals Epidemiological Properties of Primary Open Angle Glaucoma in Nigeria

2013 ◽  
Vol 2013 ◽  
pp. 1-6 ◽  
Author(s):  
Lawan Abdu
Keyword(s):  
Intraocular Pressure ◽  
Primary Open Angle Glaucoma ◽  
Open Angle Glaucoma ◽  
High Reliability ◽  
Treatment Options ◽  
Late Presentation ◽  
Open Angle ◽  
Long Term Effects ◽  
Eye Care

Background. Primary open angle glaucoma (POAG) is progressive chronic optic neuropathy in adults in which intraocular pressure (IOP) and other currently unknown factors contribute to damage. POAG is the second commonest cause of avoidable blindness in Nigeria.Pattern of Presentation. POAG is characterized by late presentation. Absence of pain which is a driving force for seeking medical help, inadequacy of trained eye care personnel, paucity of facilities, misdistribution of resources, lack of awareness, poor education, and poverty may all contribute to this. Medical and surgical treatment options available are challenging and tasking.Screening for Glaucoma. Screening is the presumptive identification of unrecognized disease (POAG) by applying test(s) which can be applied rapidly. Such test(s) should be of high reliability, validity, yield, acceptable, and cost effective. The test should ideally be sensitive, specific, and efficient. It is difficult to select a suitable test that meets these criteria. Intraocular pressure (IOP) appears to be the easiest option. But, high IOP is not diagnostic nor does normal value exclude the disease. Health education is a possible strategy in early case detection and management.Treatment of POAG. Glaucoma treatment can either be medical or surgical (this includes laser). Considering unavailability, potency, cost, and long-term effects of medication, surgery (trabeculectomy) could be a better option. Laser trabeculoplasty is available in a few centers. Viscocanalostomy is not routinely performed. Patient education is vital to success as management is for life.Conclusion. POAG remains a cause of avoidable blindness in Nigeria. There is need for long-term strategy to identify patients early and institute prompt management. Improvement in training of eye care personnel and provision of up to date equipment is essential in achieving this goal.

scholarly journals Genital tuberculosis and infertility

2017 ◽  
Vol 6 (8) ◽  
pp. 3514 ◽  
Author(s):  
Prajakta Shende ◽  
Shalini Mahana Valecha ◽  
Manisha Gandhewar ◽  
Diwija Dhingra
Keyword(s):  
Treatment Options ◽  
Long Term Effects ◽  
Genital Tuberculosis ◽  
Clinical Criteria ◽  
High Incidence ◽  
Short And Long Term ◽  
Tb Pcr ◽  
A Prospective Study ◽  
Strong Suspicion

Background: An analytical study to diagnose genital tuberculosis, using various modalities, it`s treatment options and fertility outcomes in infertile labour class women.Methods: A prospective study, where 120 women, presented to hospital due to infertility were subjected to hystero-laparoscopy over 36 months. Endometrium sent for TB-PCR and HPR. Those diagnosed with GTB were given Anti-Tubercular Drugs as per standard regimes and their fertility outcome was studied.Results: Out of 120 women, 32(27%) were diagnosed with GTB using accepted clinical criteria, TB-PCR and endometrial HPR. 30 of these 32 were diagnosed by HLscopic picture (94%) alone, 18 by positive endometrial TB-PCR (58%) and another 3 by HPR (10%). Among 32 women treated, 9(28%) conceived after treatment.Conclusions: High incidence of GTB amongst the labour class warrants strong suspicion and early diagnosis using hystero-laparoscopy and prompt treatment to minimize the short and long-term effects of GTB on fertility.

scholarly journals Adverse Events Involving Hallux Metatarsophalangeal Joint Implants: Comprehensive Analysis of US Food and Drug Administration Data from 2010 to 2018

2020 ◽  
Vol 5 (4) ◽  
pp. 2473011420S0009
Author(s):  
Craig C. Akoh ◽  
Rishin J. Kadakia ◽  
Jie Chen ◽  
Young-uk Park ◽  
Hyong Nyun Kim ◽  
...  
Keyword(s):  
Adverse Events ◽  
Treatment Options ◽  
Metatarsophalangeal Joint ◽  
Long Term Effects ◽  
Modes Of Failure ◽  
The Us ◽  
User Facility ◽  
Joint Implants ◽  
Component Loosening

Category: Midfoot/Forefoot; Other Introduction/Purpose: The prevalence of osteoarthritis of the hallux metatarsophalangeal joint (MTPJ) is estimated to affect 1 in 40 people over the age of 50. Surgical treatment options for MTPJ arthritis include joint preservation, joint resurfacing, and salvage arthrodesis. Arthroplasty of the great toe MTPJ has evolved over the past several decades. The aims of this study were to examine the MAUDE database to determine reported adverse events for hallux MTPJ arthroplasty. Methods: The US Food and Drug Administration’s (FDA) Manufacturer and User Facility Device Experience (MAUDE) database was reviewed from 2010-2018 to determine reported adverse events for approved implants. We recorded and categorized the type of adverse event and excluded duplicate reports and those extracted from already published literature. Results: Among 64 unique hallux MTPJ implant adverse events, the most common modes of failure were component loosening (34%), component fracture (9.4%), inflammation (9.4%), infection (14.1%), and allergic reaction (7.8%). In regards to implant type, synthetic implants (Cartiva) had the highest percentage of adverse events (23.4%), followed by Arthrosurface ToeMotion (20.3%), Ascension MGT (12.5%), Arthrosurface HemiCAP (10.9%), Futura primus (9.4%), and Osteomed Reflexion (6.3%). The number of adverse events reported increased substantially after 2016. Conclusion: Our study of the MAUDE database demonstrated that component loosening and infection are the most common modes of adverse events for hallux MTPJ implants. Cartiva accounted for one-fourth of the implant-related adverse events during our study period, followed by ToeMotion and Ascension MGT implants. Given that the adverse events for hallux MTPJ implants are underreported, improved reporting mechanisms should be utilized to improve our understanding on long-term effects of various hallux MTPJ implants. [Table: see text]

Vascular malformations revisited

VASA ◽  
2015 ◽  
Vol 44 (1) ◽  
pp. 5-22 ◽  
Author(s):  
Robert K. Clemens ◽  
Thomas Pfammatter ◽  
Thomas O. Meier ◽  
Ahmad I. Alomari ◽  
Beatrice R. Amann-Vesti
Keyword(s):  
Gold Standard ◽  
Multidisciplinary Approach ◽  
Vascular Malformations ◽  
Treatment Options ◽  
Reduce Blood Loss ◽  
Significant Morbidity ◽  
Treatment Techniques ◽  
New Treatment ◽  
Common Understanding

Vascular malformations are congenital anomalies that can affect each part of the vasculature. Combined forms are common and they are often part of complex syndromes. Most malformations are diagnosed during infancy, but some get obvious only later in life. The field of vascular malformations is emerging with recently described new entities and treatments. Still, misdiagnosis is common in this field, leading to nosologic confusion and wrong treatment. Clinical evaluation and imaging are the gold standard for diagnostic confirmation. Sclerotherapy and embolization are the main treatment techniques but are also used preoperatively to reduce blood loss and shrink the lesion if surgery is planned. Despite new treatment options, especially if extensive in size or involving vulnerable structures, vascular malformations are still considered chronic diseases and cause significant morbidity. Common understanding and agreement on terminology and a multidisciplinary approach are the basis of successful treatment and long-term support for these patients. Continuing research in the field of vascular anomalies will improve knowledge and create further treatment options.

Seventeen-Year Follow-up After Meniscal Repair With Concomitant Anterior Cruciate Ligament Reconstruction in a Pediatric and Adolescent Population

2018 ◽  
Vol 46 (14) ◽  
pp. 3361-3367 ◽  
Author(s):  
Adam J. Tagliero ◽  
Vishal S. Desai ◽  
Nicholas I. Kennedy ◽  
Christopher L. Camp ◽  
Michael J. Stuart ◽  
...  
Keyword(s):  
Acl Reconstruction ◽  
Clinical Success ◽  
Cruciate Ligament ◽  
Meniscal Repair ◽  
Clinical Success Rate ◽  
Adolescent Population ◽  
Long Term Follow Up ◽  
Anterior Cruciate

Background: Studies have shown good and excellent clinical and radiographic results after meniscal repair. Limited published information exists on the long-term outcomes, however, especially in a pediatric and adolescent population. Purpose: To determine long-term results of meniscal repair and concomitant anterior cruciate ligament (ACL) reconstruction in a pediatric and adolescent population. Specifically, the aims were to determine the clinical success rate of meniscal repair with concomitant ACL reconstruction, compare results with midterm outcomes, and analyze risk factors for failure. Study Design: Case series; Level of evidence, 4. Methods: Cases of meniscal repair with concomitant ACL reconstruction between 1990 and 2005 were reviewed among patients aged ≤18 years. Patient demographics, injury history, and surgical details were recorded, and risk factors for failure were analyzed. Physical examination findings and clinical outcomes at latest available follow-up were collected. Subjective knee outcomes were compared with midterm results. Descriptive statistics and univariate analysis were used to evaluate the available data. Results: Forty-seven patients (30 females, 17 males) with a mean age of 16 years (SD, 1.37) and a mean follow-up of 16.6 years (SD, 3.57) were included in this study. Overall, 13 patients (28%) failed meniscal repair and required repeat surgery at the time of final follow-up. Of the 13 failures, 9 underwent a subsequent meniscectomy; 2, meniscectomy and revision ACL reconstruction; 1, meniscal repair and revision ACL reconstruction; and 1, meniscal repair and subsequent meniscectomy. Mean International Knee Documentation Committee scores improved from 47.9 preoperatively to 87.7 postoperatively ( P < .01), and the mean score at long-term follow-up (87.7) did not significantly differ from that at the midterm follow-up (88.5) at a mean 7.4 years ( P = .97). Mean Tegner Activity Scale scores improved from 1.9 preoperatively to 6.3 postoperatively ( P < .01) and decreased from 8.3 at preinjury to 6.3 at final long-term follow-up ( P < .01). Conclusion: In conclusion, the long-term overall clinical success rate (failure-free survival) was 72% for repair of pediatric and adolescent meniscal tears in the setting of concomitant ACL reconstruction. Patients reported excellent knee subjective outcome scores that remained favorable when compared with midterm follow-up.

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