Should the Diastatic Syndesmosis be Stabilized in Advanced Pronation-External Rotation Ankle Injuries? A Retrospective Cohort Comparison

Abstract Background: Ankle injuries with the advanced pronation-external rotation (PE) type are relatively uncommon and the debate about whether the diastatic syndesmosis should be stabilized concomitantly has yet achieved a consensus. Comparison of using (Group 1) or non-using (Group 2) screw stabilization for the diastatic syndesmosis was performed retrospectively. Methods: With the 10-year period, 81 consecutive adult patients with advanced PE ankle injuries (stage 3 or 4 PE type) were treated. After malleolar fractures were internally stabilized with screws and plates, the syndesmotic stability was re-checked by external rotation and hook tests. The necessity of insertion of cortical screws to stabilize diastatic syndesmosis was decided by the individual orthopedic surgeon. The outcomes of both approaches were compared. Results: Seventy-one patients were followed for at least one year (87.7%; average, 2 years; range, 1-11 years). Group 1 had 22 patients and Group 2, 49 patients. The union rate in Group 1 was 100% (22 / 22) and in Group 2, 91.8% (45 / 49; p= 0.30). Syndesmosis re-diastasis occurred in 13.6% (3 / 22) of Group 1 and 30.6% (15 / 49) of Group 2 (p= 0.13). Satisfactory ankle function was noted in 86.4% (19 / 22) of Group 1 and 65.3% (32 / 49) of Group 2 (p= 0.07). Conclusion: Although clinical comparison cannot demonstrate statistical difference, screw stabilization of the diastatic syndesmosis may guarantee safer results. The statistical insignificance may be due to insufficient sample sizes. Clinically and theoretically, insertion of syndesmotic screws to promote ligament healing may be reasonable.

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Intracoronary Injection of Autologous CD34+ Cells Improves One-Year Left Ventricular Systolic Function in Patients with Diffuse Coronary Artery Disease and Preserved Cardiac Performance—A Randomized, Open-Label, Controlled Phase II Clinical Trial

Journal of Clinical Medicine ◽

10.3390/jcm9041043 ◽

2020 ◽

Vol 9 (4) ◽

pp. 1043 ◽

Cited By ~ 2

Author(s):

Pei-Hsun Sung ◽

Yi-Chen Li ◽

Mel S. Lee ◽

Hao-Yi Hsiao ◽

Ming-Chun Ma ◽

...

Keyword(s):

Systolic Function ◽

Coronary Intervention ◽

Left Ventricular ◽

Diffuse Coronary Artery Disease ◽

Cd34 Cells ◽

Group 2 ◽

Artery Disease ◽

One Year ◽

Lv Systolic Function ◽

Group 1

This phase II randomized controlled trial tested whether intracoronary autologous CD34+ cell therapy could further improve left ventricular (LV) systolic function in patients with diffuse coronary artery disease (CAD) with relatively preserved LV ejection fraction (defined as LVEF >40%) unsuitable for coronary intervention. Between December 2013 and November 2017, 60 consecutive patients were randomly allocated into group 1 (CD34+ cells, 3.0 × 107/vessel/n = 30) and group 2 (optimal medical therapy; n = 30). All patients were followed for one year, and preclinical and clinical parameters were compared between two groups. Three-dimensional echocardiography demonstrated no significant difference in LVEF between groups 1 and 2 (54.9% vs. 51.0%, respectively, p = 0.295) at 12 months. However, compared with baseline, 12-month LVEF was significantly increased in group 1 (p < 0.001) but not in group 2 (p = 0.297). From baseline, there were gradual increases in LVEF in group 1 compared to those in group 2 at 1-month, 3-months, 6-months and 12 months (+1.6%, +2.2%, +2.9% and +4.6% in the group 1 vs. −1.6%, −1.5%, −1.4% and −0.9% in the group 2; all p < 0.05). Additionally, one-year angiogenesis (2.8 ± 0.9 vs. 1.3 ± 1.1), angina (0.4 ± 0.8 vs. 1.8 ± 0.9) and HF (0.7 ± 0.8 vs. 1.8 ± 0.6) scores were significantly improved in group 1 compared to those in group 2 (all p < 0.001). In conclusion, autologous CD34+ cell therapy gradually and effectively improved LV systolic function in patients with diffuse CAD and preserved LVEF who were non-candidates for coronary intervention (Trial registration: ISRCTN26002902 on the website of ISRCTN registry).

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Effect of anterior capsular polishing on the incidence of YAG capsulotomy

Annals of King Edward Medical University ◽

10.21649/akemu.v11i3.1021 ◽

2016 ◽

Vol 11 (3) ◽

Author(s):

Muhammad A Ahad ◽

Mohammad Rashad Qamar ◽

Sameh K Hindi ◽

Martin N Kid

Keyword(s):

Outcome Measure ◽

Early Postoperative Period ◽

Controlled Study ◽

Control Group ◽

Anterior Capsule ◽

Main Outcome Measure ◽

Group I ◽

Group 2 ◽

One Year ◽

Group 1

Purpose: To study the effect of anterior capsule polishing during phacoemulsification on the incidence of post operative YAG laser capsulotomy. Method: A retrospective controlled study of 159 patients who underwent uncomplicated phacoemulsification with anterior capsular polishing between October 1998 and March 2000. 169 age matched patients who underwent phacoemulsification but without anterior capsule polishing served as controls. Main outcome measure: Incidence of visually significant YAG capsulotomy, which improved the Snellen acuity for more than 1 line or at least 1 line with subjective improvements in symptoms. Results: 2.51 % of patients with anterior capsular polishing (Group 1) had YAG capsulotomy compared to 7.1% of patients in control group at one year. However, after two years, 11.3% of patients in Group I had YAG capsulotomy compared to 12.4% in Group 2. Conclusion: Anterior capsular polishing during cataract surgery may delay the opacification of posterior capsule during the early postoperative period. But does not decrease the incidence of YAG capsulotomy after two years.

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Pulsed Radiofrequency for Chronic Inguinal Neuralgia

January 2018 - Pain Physician ◽

10.36076/ppj/2015.18.e147 ◽

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

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The difference in outcome of patients with open inguinal hernia repair by using delayed absorbable sutures instead of non-absorbable sutures for mesh fixation

International Surgery Journal ◽

10.18203/2349-2902.isj20205423 ◽

2020 ◽

Vol 8 (1) ◽

pp. 24

Author(s):

Ali G. Mohammed Redha ◽

Adil A. Jaber ◽

Aqeel M. Nasser

Keyword(s):

Hernia Repair ◽

Mesh Fixation ◽

Good Alternative ◽

P Value ◽

Absorbable Sutures ◽

Significant Difference ◽

The Difference ◽

Group 2 ◽

One Year ◽

Group 1

Background: Different methods are found for mesh fixation in inguinal hernioplasty both open and laparoscopic. In open technique, sutures have been the method of choice for their reduced costs and surgeons’ habits. Whether absorbable instead of non-absorbable sutures can be used still a matter of debate in view of hernia recurrence and post-operative complications.Methods: This is a prospective done on 158 male patients with uncomplicated unilateral inguinal hernias. Two groups of 69 patients were evaluated after periods up to 1 year after open hernioplasty by using delayed absorbable sutures in one group (group 1) and non-absorbable sutures in the other group (group 2) for fixation of mesh.Results: In spite of a noticeable reduction in complication in the group 1 in term of number and percentage when compared with group 2 mainly chronic pain, there is no significant difference (p value>0.05). However, these results are associated with zero recurrence in both groups during a period of one year follow up.Conclusions: Delayed absorbable sutures are good alternative of non-absorbable sutures in open mesh hernia repair associated with less complications and almost no increase in chance of recurrence.

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Drug-eluting balloon treatment in femoropopliteal in-stent restenosis of different lengths

Turkish Journal of Thoracic and Cardiovascular Surgery ◽

10.5606/tgkdc.dergisi.2020.18980 ◽

2020 ◽

Vol 28 (3) ◽

pp. 460-466

Author(s):

Berkan Özpak

Keyword(s):

Stent Restenosis ◽

Significant Difference ◽

Stent Length ◽

Drug Eluting ◽

Group 3 ◽

Group 2 ◽

Drug Eluting Balloon ◽

One Year ◽

In Stent Restenosis ◽

Group 1

Background: In this study, we present one-year results of drug-eluting balloon treatment of femoropopliteal in-stent restenosis. Methods: A total of 62 patients (48 males, 14 females; mean age 64.2±9.1 years; range, 54 to 81 years) who underwent drug-eluting balloon stenting for femoropopliteal in-stent restenosis between August 2013 and October 2017 were included in the study. The patients were classified into three groups based on the narrowing length of stenosis in the stents. Group/Class 1 (n=17): narrowing <1/2 of the stent length; Group/Class 2 (n=22): narrowing >1/2 of the stent length, not totally occluded; and Group/Class 3 (n=23): totally occluded. In-stent restenosis was treated with drug-eluting balloon treatment. Results: There was a significant difference among all classes in terms of in-stent restenosis. The length of stenosis was a predictor for in-stent restenosis. The mean stent length was 107.7±24.6 mm in Group 1, 164.6±17.9 mm in Group 2, and 180±19.3 mm in Group 3. For non-occluded in-stent restenosis, restenosis rate at one year after balloon angioplasty was 47.1% in Group 1, 86.4% in Group 2, and 95.7% in Group 3. Femoropopliteal bypass was performed in five patients in whom treatment failed. None of the patients required amputation. Conclusion: The length of in-stent restenosis in the femoropopliteal arterial stents is an important predictor for recurrent stenosis, when re-flow is achieved with drug-eluting balloons.

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Short versus standard PFN outcome analysis in unstable intertrochantric fracture

International Journal of Research in Orthopaedics ◽

10.18203/issn.2455-4510.intjresorthop20183675 ◽

2018 ◽

Vol 4 (5) ◽

pp. 747

Author(s):

Pravin Kumar Jangde ◽

Anant Kumar Singh

Keyword(s):

Hip Fractures ◽

Trochanteric Fracture ◽

The Elderly ◽

Outcome Analysis ◽

Femoral Canal ◽

Femoral Nail ◽

Group 2 ◽

One Year ◽

Group B ◽

Group 1

Background: Hip fractures in the elderly are frequent. Intertrochanteric hip fractures account for approximately half of all hip fractures in the elderly; of these, from 50% to 60% are classified as unstable. In our study we tried to compare outcome of unstable trochantric fracture in terms length of PFN (180 vs 240 mm).Methods: 80 patients of unstable trochanteric fracture were randomly allotted to 2 groups who were treated with closed reduction and internal fixation with proximal femoral nail of size 180 mm(group A) and 240mm (group B). Patients in both the group were compared right from the fracture configuration till the one year post-operative period.Results: In the study of 80 patients there were 18 males (45%) and 22 females (55%) in group 1, and 23 male (57%) and 17 female (42.5%) in group 2. Group 1 patient had a better range of movements than group 2. Femoral canal impingement was present in 6 (15%) of patients of group 1 and 28(70%) patients of group 2 showed femoral canal impingement.Conclusions: There are very few studies which compare the length of PFN to the outcome. The standard PFN group presented with complications like femoral nail impingement and hence more thighs pain and less range of movements even after one year of follow up. We conclude that for Indian group of population who have a relatively short femora gives a better result with a shorter length implant.

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Symptomatic and diagnostic stability in schizophrenia: a one-year follow-up study

European Psychiatry ◽

10.1017/s0924933800001917 ◽

1993 ◽

Vol 8 (3) ◽

pp. 131-137 ◽

Cited By ~ 1

Author(s):

S Dollfus ◽

M Petit ◽

JF Menard ◽

P Lesieur

Keyword(s):

New Haven ◽

Diagnostic Systems ◽

Residual Phase ◽

Duration Of Illness ◽

Number Of Patients ◽

Phase Group ◽

Group 2 ◽

One Year ◽

The Stability ◽

Group 1

SummaryThe stability of symptomatology and of eleven schizophrenic diagnostic systems was studied in patients initially in an acute phase (group 1) compared to patients in a residual phase (group 2). The patients were evaluated over a period of 1 year with a standardized checklist and PANSS in both groups. The number of patients included by the Carpenter, Calego, 1CD9, New-Haven, Schneider and Vienne systems decreased significantly between admission and discharge in group 1, whereas no variation was observed in group 1 between discharge and one year later, or in group 2 over a period of 1 year. The instability of schizophrenic diagnostic systems such as New-Haven, Schneider and Vienne could be due to the variation of positive or general symptomatology. The number of patients included by Feighner or Langfeldt did not vary significantly between admission and discbarge in group 1, in spite of a significant decrease in symptomatology, probably because certain criteria, such as duration of illness, hindered the systems from changing. The results showed the importance of specifying in every study on schizophrenia the time of inclusion (admission, discharge) or the phase of illness (acute or residual phase).

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Arthroscopic Bankart repair with knotless suture anchors: A comparison of the permanent and absorbable types

Journal of Orthopaedics Trauma and Rehabilitation ◽

10.1177/2210491720953595 ◽

2020 ◽

Vol 27 (2) ◽

pp. 202-207

Author(s):

Abdulrahman D Algarni

Keyword(s):

External Rotation ◽

Shoulder Function ◽

Bankart Repair ◽

Suture Anchors ◽

Glenohumeral Instability ◽

Arthroscopic Bankart Repair ◽

Significant Difference ◽

Functional Scores ◽

Group 2 ◽

Group 1

Aim: The aim of this study was to compare the clinical outcomes of arthroscopic Bankart repair (ABR) using two types of knotless suture anchors (KSAs) in patients with post-traumatic recurrent anterior glenohumeral instability (AGHI). Methods: Thirty-two patients underwent an ABR using KSAs: a permanent KSA (PushLock) and an absorbable counterpart (BioKnotless). There were 16 patients in each group. Pre-and post-operative assessment for shoulder function using the American Shoulder and Elbow Surgeons and Constant–Murley scores, recurrence of instability, post-operative limitation of external rotation (ER) and ability to return to pre-injury level were recorded in both groups. Results: Both groups displayed significant improvements in functional scores ( p < 0.0001) without a significant difference between the groups. Of the 32 patients, 9.4% had recurrence of instability (one re-dislocation in group 1 and two symptomatic subluxations in group 2). Return to pre-injury level occurred in 87.5% and 81.3% of group 1 and group 2, respectively. There was 2° to 3° loss of ER after ABR in both groups; the difference between the groups was not significant ( p = 0.45). Conclusion: ABR for recurrent AGHI using a permanent or absorbable KSA offers comparable successful outcomes; no significant statistical difference was found.

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Contemporaneous Portal-Arterial Reperfusion during Liver Transplantation: Preliminary Results

Journal of Transplantation ◽

10.1155/2011/251656 ◽

2011 ◽

Vol 2011 ◽

pp. 1-4 ◽

Cited By ~ 7

Author(s):

G. L. Adani ◽

A. Rossetto ◽

V. Bresadola ◽

D. Lorenzin ◽

U. Baccarani ◽

...

Keyword(s):

Liver Transplantation ◽

Hepatic Artery ◽

Graft Survival ◽

Meld Score ◽

Warm Ischemia ◽

Biliary Strictures ◽

Arterial Revascularization ◽

Group 2 ◽

One Year ◽

Group 1

We prospectively compared sequential portal-arterial revascularization (SPAr, group 1 no. 19) versus contemporaneous portal-hepatic artery revascularization (CPAr, group 2 no. 21) in 40 consecutive liver transplantation (LT). There were no differences in the demographics characteristics, MELD score, indication to LT, and donor's parameters between the two groups. CPAr had longer warm ischemia66±8versus37±7min (P<.001), while SPAr had longer arterial ischemia103±42 min (P=.0004). One-year patient's and graft survival were, respectively, 89% and 95% versus 94% and 100% (P=.29). At median followup of13±6versus14±7months biliary complications were anastomotic stenosis in 15% versus 19% (P=.78), and intrahepatic nonanastomotic biliary strictures in 26% versus none (P=.01), respectively, in SPAr and CPAr. CPAr reduces the incidence of intrahepatic biliary strictures by decreasing the duration of arterial ischemia.

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Single versus Multiple Dose Ivermectin Regimen in Onchocerciasis-Infected Persons with Epilepsy Treated with Phenobarbital: A Randomized Clinical Trial in the Democratic Republic of Congo

Pathogens ◽

10.3390/pathogens9030205 ◽

2020 ◽

Vol 9 (3) ◽

pp. 205 ◽

Cited By ~ 4

Author(s):

Michel Mandro ◽

Joseph Nelson Siewe Fodjo ◽

Alfred Dusabimana ◽

Deby Mukendi ◽

Steven Haesendonckx ◽

...

Keyword(s):

Clinical Trial ◽

Seizure Frequency ◽

Democratic Republic ◽

Democratic Republic Of Congo ◽

Analysis Data ◽

Seizure Freedom ◽

Republic Of Congo ◽

Group 2 ◽

One Year ◽

Group 1

Background: There is anecdotal evidence that ivermectin may decrease seizure frequency in Onchocerca volvulus-infected persons with epilepsy (PWE). Methods: In October 2017, a 12-month clinical trial was initiated in rural Democratic Republic of Congo. PWE with onchocerciasis-associated epilepsy experiencing ≥2 seizures/month were randomly allocated to receive, over a one-year period, ivermectin once or thrice (group 1), while other onchocerciasis-infected PWE (OIPWE) were randomized to ivermectin twice or thrice (group 2). All participants also received anti-epileptic drugs. Data was analyzed using multiple logistic regression. Results: We enrolled 197 participants. In an intent-to-treat analysis (data from group 1 and 2 combined), seizure freedom was more likely among OIPWE treated with ivermectin thrice (OR: 5.087, 95% CI: 1.378–19.749; p = 0.018) and twice (OR: 2.471, 95% CI: 0.944–6.769; p = 0.075) than in those treated once. Similarly, >50% seizure reduction was more likely among those treated with ivermectin twice (OR: 4.469, 95% CI: 1.250–16.620) and thrice (OR: 2.693, 95% CI: 1.077–6.998). Absence of microfilariae during the last 4 months increased the odds of seizure freedom (p = 0.027). Conclusions: Increasing the number of ivermectin treatments was found to suppress both microfilarial density and seizure frequency in OIPWE, suggesting that O. volvulus infection plays an etiological role in causing seizures.

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