scholarly journals Subaxial Lordosis Loss and Influence Factors After Posterior Atlantoaxial Fusion

2021 ◽  
Author(s):  
Shaoqiang Liu ◽  
Boling Liu ◽  
Guiqing Liang ◽  
Qiyong Chen ◽  
Huafeng Wang ◽  
...  
Keyword(s):  
Risk Factor ◽  
Influence Factors ◽  
Cervical Disc ◽  
Chi Square ◽  
Atlantoaxial Fusion ◽  
Cervical Sagittal Balance ◽  
Plain Films ◽  
Sagittal Parameters ◽  
Chi Square Analysis

Abstract Summary of Background Data: Cervical sagittal balance, an important evaluation index of cervical physiological function and surgical efficacy. Subaxial kyphosis after atlantoaxial fusion is negatively associated with worse clinical outcome and higher incidence of lower cervical disc degeneration. Objectives: This study aimed to confirm the factors that influence subaxial lordosis loss after posterior atlantoaxial fusion. Methods: We performed a retrospective review of all patients following posterior C1-C2 fusion for atlantoaxial dislocation between January 2015 and December 2017. All charts, records, and imaging studies were reviewed for each case, and preoperative, immediate postoperative, and final follow-up plain films were evaluated. Comparing final follow-up and preoprative C2-C7 angle, patients were divided into two groups for further comparison: subaxial lordosis loss group and subaxial lordosis increase group.Results: A total of 18 patients were included in the review, with an average radiographic follow-up of 8.4 ± 3.7 months (range, 6 to 17 months). Subaxial lordosis loss was observed in 5 cases (27.8%) at the final follow-up, whereas 13 cases had an increase of subaxial lordosis. The cervical sagittal parameters of preoperative and final follow-up between two groups were compared, the preoperative C2-C7 angle of the subaxial lordosis loss group was bigger than the subaxial lordosis increase group (27.6°±10.5° vs 10.5°±10.5°, P<0.05), but there was no statistical difference in other parameters. Univariate chi-square analysis showed that reduction of subaxial lordosis after posterior atlantoaxial fusion was associated with preoperative C2-C7 angle ≥20° (χ2=4.923, P=0.026). However, Logistic regression analysis showed that the preoperative C2-C7 angle ≥20° was not an independent risk factor (OR=0.147, P=0.225). Conclusion: Our study demonstrates that subaxial lordosis loss may occur after posterior atlantoaxial fusion, and preoperative C2-C7 angle ≥20° was a risk factor of postoperative loss of subaxial lordosis.

New Perspectives on Risk Factors for Non-fatal Strangulation and Post-assault Imaging

2020 ◽  
pp. 088626052096667
Author(s):  
Grace B. McKee ◽  
Kathy Gill-Hopple ◽  
Daniel W. Oesterle ◽  
Leah E. Daigle ◽  
Amanda K. Gilmore
Keyword(s):  
Sexual Assault ◽  
Partner Violence ◽  
Intimate Partner ◽  
Chi Square ◽  
Factors Associated ◽  
Bodily Injury ◽  
Weapon Use ◽  
Chi Square Analysis ◽  
Assault Characteristics

Strangulation has long been associated with death in the context of sexual assault and intimate partner violence (IPV). Non-fatal strangulation (NFS) during sexual assault, which refers to strangulation or choking that does not result in death, is common and has been associated with IPV and with bodily injury; however, other factors associated with NFS are unknown. The current study examined demographic and sexual assault characteristics associated with NFS among women who received a sexual assault medical forensic exam (SAMFE). A second purpose of this study was to explore factors associated with receiving follow-up imaging orders after NFS was identified during a SAMFE. Participants ( N = 882) ranged in age from 18 to 81 ( M = 28.85), with the majority identifying as non-Hispanic White (70.4%) or Black/African American (23.4%). A total of 75 women (8.5%) experienced NFS during the sexual assault. Of these, only 13 (17.3%) received follow-up imaging orders for relevant scans. Results from a logistic regression analysis demonstrated that NFS was positively associated with report of anal penetration, intimate partner perpetration, non-genital injury, and weapon use during the assault. Results from chi-square analysis showed that among sexual assaults involving women who experienced NFS, those whose assaults involved weapon use were over four times more likely to receive imaging orders compared to assaults without weapon use. These findings have implications for criminal justice, and if incorporated into danger assessments, could potentially reduce fatalities linked to sexual assault and/or IPV. Additional work is needed to ensure that all assaults with NFS trigger a referral for imaging regardless of other assault characteristics.

The Prevalence of Persistent Intradialytic Hypertension in a Hemodialysis Population with Extended Follow-Up

2012 ◽  
Vol 35 (12) ◽  
pp. 1031-1038 ◽  
Author(s):  
Peter N. Van Buren ◽  
Catherine Kim ◽  
Robert D. Toto ◽  
Jula K. Inrig
Keyword(s):  
Blood Pressure ◽  
Linear Models ◽  
Hemodialysis Patients ◽  
Weight Changes ◽  
Mixed Linear Models ◽  
Ultrafiltration Rate ◽  
Chi Square ◽  
Median Percentage ◽  
Chi Square Analysis

Background Intradialytic hypertension, a phenomenon where blood pressure increases during hemodialysis, is associated with increased mortality in hemodialysis patients. The proportion of patients in which intradialytic hypertension persists over time is unknown. Methods In a retrospective cohort study, we studied all patients from our outpatient hemodialysis units that received ≥1 month of treatments during the period from January to August 2010. We reviewed all pre- and post-hemodialysis blood pressure and weight measurements from 22,955 treatments during this study period. We defined intradialytic hypertension as an increase in systolic blood pressure ≥10 mmHg from pre- to post-hemodialysis. Individual patients were defined as having persistent intradialytic hypertension if the change in blood pressure from pre- to post-hemodialysis, when averaged throughout the study period, was ≥+10 mmHg. We calculated weight changes between and during hemodialysis and defined ultrafiltration rate per treatment as ultrafiltration volume divided by minutes on hemodialysis. We compared patients with and without persistent intradialytic hypertension using chi-square analysis and mixed linear models. Results The prevalence of intradialytic hypertension was 21.3 per 100 treatments. The median percentage of intradialytic hypertension treatments per patient was 17.8% (9–31.3%, interquartile range). The prevalence of persistent intradialytic hypertension was 8 per 100 patients. Patients with persistent intradialytic hypertension had lower ultrafiltration rate compared to other patients (10.4 vs. 12.2 ml/min, p = 0.02). Conclusions Intradialytic hypertension is a persistent phenomenon in a subset of hemodialysis patients. Ultrafiltration rate was the only volume-related variable that differed between patients with and without persistent intradialytic hypertension.

Outcomes of Arch Reintervention for Recurrent Coarctation in Young Children

2021 ◽  
Author(s):  
Qi Jiang ◽  
Renjie Hu ◽  
Wei Dong ◽  
Ying Guo ◽  
Wen Zhang ◽  
...  
Keyword(s):  
Risk Factor ◽  
Young Children ◽  
Confidence Interval ◽  
Surgical Repair ◽  
Three Dimensional ◽  
Chi Square ◽  
Late Mortality ◽  
Chi Square Test ◽  
Surgical Group

Abstract Objectives To evaluate the outcomes of reintervention for postrepair recoarctation in young children. Methods Between January 2011 and December 2020, all consecutive patients aged ≤3 years who were treated for postrepair recoarctation were included. Recoarctations were classified into two morphological types by three-dimensional imaging. Two methods, namely, surgical repair and balloon angioplasty (BA), were used to treat recoarctation. Results This study included 50 patients with a median age of 10.5 months (range, 2.0–36.0 months) and a mean weight of 9.3 ± 3.1 kg. Hypoplastic recoarctation occurred most frequently in patients who had undergone patch aortoplasty at initial repair (p = 0.001). No hospital mortality occurred, and all patients achieved an increased diameter (p < 0.001) and a decreased pressure gradient (p < 0.001) at the recoarctation site immediately after reintervention. The median follow-up time after reintervention was 3.5 years (range, 16.0 days–9.6 years). Late mortality occurred in four patients (8.0%): two in the surgical group and two in the BA group (chi-square test= 0.414, p = 0.520). There was no difference in arch reobstruction after reintervention between the surgical and BA groups (chi-square test = 1.383, p = 0.240). Recoarctation with a hypoplastic morphology was the leading risk factor for arch reobstruction after reintervention (hazard ratio, 6.552; 95% confidence interval, 2.045–20.992; p = 0.002). Conclusion Reintervention for recoarctation has favorable early outcomes in young children. However, late mortality is not rare, and arch reobstruction is common during close follow-up. For young children, recoarctation with hypoplastic morphology is the leading risk factor for reobstruction, while the choice of reintervention method exerts little effect on the outcomes of arch reintervention.

scholarly journals Risk Factor Analysis of Recurrent Diarrhea on Toddlers in Sumberjambe Health Center Jember Regency

2020 ◽  
Vol 6 (1) ◽  
pp. 43
Author(s):  
Anita Margaret Wibisono ◽  
Ancah Caesarina Novi Marchianti ◽  
Dion Krismashogi Dharmawan
Keyword(s):  
Risk Factors ◽  
Logistic Regression ◽  
Risk Factor ◽  
Health Center ◽  
Exclusive Breastfeeding ◽  
Family Income ◽  
Sampling Technique ◽  
Chi Square ◽  
Chi Square Test ◽  
Chi Square Analysis

Recurrent diarrhea is diarrhea that occurs repeatedly within one to three months. Toddler is the highest group suffering of diarrhea. Diarrhea is the second leading cause of death on toddler. This research aims to analyze the effect of risk factors of recurrent diarrhea on toddler in Sumberjambe Health Center Jember Regency. This type of research is observational analytic with case control design. The sample is 50 cases and 50 controls. The sampling technique used consecutive sampling method. The research was conducted in December 2018 to January 2019 using a questionnaire. Data analysis using Chi Square test and Logistic Regression test. Chi Square analysis results are child’s age (p= 0.003), gender (p= 1,000), exclusive breastfeeding (p= 0.044), measles immunization (p= 0.387), nutritional status (p= 0.840), hand nail hygiene (p= 0.395), mother’s age (p= 0.435), mother’s education level (p= 0.263), mother’s knowledge (p= 0.494), hand washing habit (p= 0.684), and family income (p= 0.773). Logistic Regression analysis results are child’s age (p= 0.002) and exclusive breastfeeding (p= 0.499). The conclusions of this study are child’s age and exclusive breastfeeding have influence of recurrent diarrhea on toddler and child's age is the most influential risk factor of recurrent diarrhea on toddler. The suggestion of this research is that it needs to research other risk factors and mothers are required to give exclusive breastfeeding.  Keywords: risk factors, recurrent diarrhea, toddler

After 9 Years of 3-Column Osteotomies, Are We Doing Better? Performance Curve Analysis of 573 Surgeries With 2-Year Follow-up

Neurosurgery ◽  
2017 ◽  
Vol 83 (1) ◽  
pp. 69-75 ◽  
Author(s):  
Bassel G Diebo ◽  
Virginie Lafage ◽  
Jeffrey J Varghese ◽  
Munish Gupta ◽  
Han Jo Kim ◽  
...  
Keyword(s):  
Spinal Deformity ◽  
Revision Rate ◽  
Deformity Correction ◽  
Major Complication ◽  
Osteotomy Site ◽  
Complication Rates ◽  
Performance Curve ◽  
Chi Square ◽  
Chi Square Analysis

Abstract BACKGROUND In spinal deformity treatment, the increased utilization of 3-column (3CO) osteotomies reflects greater comfort and better training among surgeons. This study aims to evaluate the longitudinal performance and adverse events (complications or revisions) for a multicenter group following a decade of 3CO. OBJECTIVE To investigate if performance of 3CO surgeries improves with years of practice. METHODS Patients who underwent 3CO for spinal deformity with intra/postoperative and revision data collected up to 2 yr were included. Patients were chronologically divided into 4 even groups. Demographics, baseline deformity/correction, and surgical metrics were compared using Student t-test. Postoperative and revision rates were compared using Chi-square analysis. RESULTS Five hundred seventy-three patients were stratified into: G1 (n = 143, 2004-2008), G2 (n = 142, 2008-2009), G3 (n = 144, 2009-2010), G4 (n = 144 2010-2013). The most recent patients were more disabled by Oswestry disability index (G4 = 49.2 vs G1 = 38.3, P = .001), and received a larger osteotomy resection (G4 = 26° vs G1 = 20°, P = .011) than the earliest group. There was a decrease in revision rate (45%, 35%, 33%, 30%, P = .039), notably in revisions for pseudarthrosis (16.7% G1 vs 6.9% G4, P = .007). Major complication rates also decreased (57%, 50%, 46%, 39%, P = .023) as did excessive blood loss (&gt;4 L, 27.2 vs 16.7%, P = .023) and bladder/bowel deficit (4.2% vs 0.7% P = .002). Successful outcomes (no complications or revision) significantly increased (P = .001). CONCLUSION Over 9 yr, 3COs are being performed on an increasingly disabled population while gaining a greater correction at the osteotomy site. Revisions and complication rate decreased while success rate improved during the 2-yr follow-up period.

scholarly journals A-29 Incidence of Invalid ImPACT Baseline Test Results on Initial and Follow-up Assessments among English-Speaking, Spanish-Speaking, and Bilingual Test-takers

2020 ◽  
Vol 35 (5) ◽  
pp. 625-625
Author(s):  
S Ott ◽  
L Gonzalez ◽  
V Ikonomou ◽  
P Schatz
Keyword(s):  
Language Proficiency ◽  
Spanish Speakers ◽  
Initial Assessment ◽  
Test Results ◽  
Chi Square ◽  
Spanish Speaking ◽  
Baseline Test ◽  
English Speaking ◽  
Chi Square Analysis

Abstract Objective To identify the rate of ImPACT baseline test results falling below cut-offs for invalidity indicators among English-speaking, Spanish-speaking, and bilingual-speaking, individuals, upon initial assessment and on a follow-up baseline. Method Participants were a large sample of test-takers who completed annual ImPACT baseline assessments in Greater Houston, TX, as a requirement for participation in club- or school-sponsored athletics. Participants were 12–18 years old (mean 15.3, SD = 1.5), predominantly male (69%), and assigned to independent groups on the basis of primary/secondary language: English (N = 9332), English/Spanish (N = 1380), or Spanish (N = 4720). A sub-sample of each group (English N = 815, English/Spanish N = 173, Spanish N = 63) completed 2 baseline assessments (mean 1.2 years between tests, SD = 0.55 years). Results Chi-square analysis revealed a significantly greater likelihood [X2(2) = 28.05; p &lt; .001] of obtaining an invalid baseline for individuals with Spanish as a First (6.3%) or Second (6.9%) Language as compared to individuals speaking only English (4.8%), with an overall rate of 5.6% across all three groups. Upon re-assessment, 5.7% of English, 19% of English-Spanish, and 0% of Spanish-speakers obtained a second “invalid” assessment. The Three Letters (Total Correct &lt; 8) and Design Memory (Learning Percentage &lt; 50) indicators were the most common contributing indicators, across all three groups. Conclusions Primary language appears to be a contributing factor in scoring below cut-offs for invalidity indicators, especially for bilingual English-Spanish speakers. The continued rate of invalidity for the English-Spanish speakers on follow baseline assessments also warrants further review. Given the retrospective nature of this study, potential influences of acculturation and language proficiency were not available and therefore, could not be assessed.

scholarly journals Is there a Difference in Outcomes between Patients who Received a Double or Triple Arthrodesis for Hindfoot Arthritis?

2020 ◽  
Vol 5 (4) ◽  
pp. 2473011420S0025
Author(s):  
Amanda H. Holleran ◽  
Judith F. Baumhauer ◽  
Jeff Houck ◽  
Daniel Homeier ◽  
Adolph S. Flemister ◽  
...  
Keyword(s):  
Physical Function ◽  
Pain Interference ◽  
Foot Deformities ◽  
Triple Arthrodesis ◽  
Chi Square ◽  
Post Surgery ◽  
Increased Risk ◽  
Patient Reported ◽  
Chi Square Analysis

Category: Hindfoot Introduction/Purpose: Triple arthrodesis has historically been considered the standard of treatment for arthritis of the hindfoot with or without deformity. The complications of this surgery including non-union, malunion, nerve injury, infection and wound healing problems can occur at any of the three joints. Double arthrodesis is capable of producing a similar reduction in degrees of motion and correction of foot deformity but may also cause less patient morbidity in regard to these complications due to one less joint being incorporated into the fusion procedure. What is unknown is the patient reported outcomes, specifically physical function (PF) and pain interference (PI) between these two procedures. The purpose of this study is to evaluate the clinical outcomes for hindfoot deformity using a triple compared to a double arthrodesis. Methods: A retrospective medical record review was performed (February 2015-December 2019), of 96 identified cases, 54 had complete data over 4 months post operation for either a double (Age = 58 (11); Body Mass Index (BMI) = 34.4 (6.0); n=24) or triple arthrodesis (Age= 55 (13); BMI = 33.0 (10.0); n = 30). Patient Reported Outcome Measurement Information System (PROMIS) physical function and pain interference were assessed at last available pre-operation and last follow up time points. Medical records were reviewed for complications (yes/no). ANOVA models were used to assess differences pre to post surgery (covariates included age, BMI, and length of follow up). Chi Square analysis was used to assess proportions of patients achieving a minimal clinically important difference (34.5) and complications by group. Results: There were no differences between groups in terms of age (p = 0.51), BMI (p = 0.44), or length of follow up (triple = 540 (334) days versus double = 390 (336) days; p=0.12). There were no significant differences in PROMIS PF (pre-post change 95% CI: triple= 1.2 (-4.1 to 1.6) versus double = 0.2 (-2.5 to 2.0)). The for PROMIS PI both groups experienced lower pain (average 5.1 (1.0) with the greater decrease in pain in the triple group (Figure 1; pre-post change 95% CI: triple= 7.1 (-10.2 to -4.0) versus double = 3 (-5.5 to -0.6)). Chi square analysis showed that a greater proportion of patients undergoing a triple (triple 61.9 % versus double 33.3 %) experienced MCID improvement in PROMIS PI (X2=4.4, p=0.04). There were 4 complications in the double group, and 6 in the triple group. Conclusion: Double arthrodesis can allow for similar correction of foot deformities without the increased risk of wound complication, infection or nonunion/malunion. However, we found that patients who underwent a triple arthrodesis were more likely to have an improvement in minimally important clinical difference (MCID) in the PROMIS pain interference scores than those who underwent a double arthrodesis.

Risk factor of growth faltering in infants aged 2-12 months

2021 ◽  
Vol 10 (1) ◽  
pp. 72-79
Author(s):  
Rina Pratiwi ◽  
Adriyan Pramono ◽  
Galuh Hardaningsih
Keyword(s):  
Risk Factor ◽  
Gestational Age ◽  
Significant Relationship ◽  
Behavioral Disorder ◽  
Chi Square ◽  
Growth Faltering ◽  
Mother’S Education ◽  
And Gender ◽  
Chi Square Analysis ◽  
Mother's Education

Background: Growth faltering is a condition of growth disturbance that marked by slower growth velocity compared with previous growth chart. Growth faltering can cause effects in immune response, cognitive, & physical and psychomotor disturbance, behavioral disorder, learning problems, higher risk of infection and mortality.Objectives: To analyze risk factor of growth faltering in infant aged 2-12 months.Materials and Methods: A case control study was conducted in Public Health Center in Semarang city. Subject were infants aged 2 until 12 months with growth faltering. Variables were divided to exclusive breastfeeding, mother’s education, mother’s employment, social economic status, infection, mother’s nutrition and gestational age. Anthropometric and questionnaire data were obtained and analyzed among 116 infants. Statistic test used Chi square and multivariate analysis.Results: Chi-square analysis showed that breastfeeding (p=0.016) and gender (p=0.04) had a significant relationship with growth faltering in infant 2-12 months. Under standard parent’s income (p=0.809), Acute Respiratory Tract Infection (ARTI) (p=0.377), diarrhea (p=0.243), mother’s nutrition (p=1.00), gestational age (p=0.77), low mother’s education (p=0.83) and working mother (p=0.26) didn’t have a significant relationship with growth faltering in infant aged 2-12 months. Multivariate analysis showed that gender (p=0.035) and breastfeeding (p=0.019) were the most influencing variable to growth faltering. In 2-6 group, breastfeeding pattern had significant relationship with growth faltering (p=0.77)Conclusions: Breastfeeding and gender were risk factors of growth faltering in infant aged 2-12 months. Further research needed on how to prevent growth faltering in first 1000 days of life so it may avoid stunting in later life.

scholarly journals Commuting Mobility as Risk Factor for Dengue Hemorrhagic Fever in Sleman Regency, Yogyakarta, Indonesia

2020 ◽  
Vol 14 (2) ◽  
pp. 58
Author(s):  
Tri Wulandari Kesetyaningsih ◽  
Siti Fajrini Amir ◽  
Yeni Rahma Desty
Keyword(s):  
Risk Factor ◽  
Dengue Hemorrhagic Fever ◽  
Human Mobility ◽  
High Mobility ◽  
Hemorrhagic Fever ◽  
Control Group ◽  
Case Group ◽  
Chi Square ◽  
Mobility Data ◽  
Chi Square Analysis

Background:In Indonesia, there has been a change in the age group of dengue hemorrhagic fever (DHF) patient population from children to adults since 1998. It raises the suspicion that an infection occurs not only in residential area but also from other places as a result of human mobility. Research on the role of people mobility as a risk factor for dengue incidence yielded different results. This study aims to reveal the relationship between human mobility and the incidence of dengue. Method: This is a case-control study that involved 276 respondents; 138 were sufferers (case group) while the other 138 respondents were non-sufferers (control group). The sample size was determined by using purposive sampling. Patient’s data and their addresses were obtained from Sleman Regency Health Office while the control group was patient’s neighbors. The people mobility data were obtained by conducting questionnaires that were divided into three categories, namely low, moderate, and high for commuting mobility and two categories, namely traveling outside and inside province for circular mobility. Chi-square analysis was used to determine whether mobility was a risk factor for DHF. Results:The result showed that commuting mobility was correlated with the DHF incidence (p=0.001) where the high mobility of 3.169 times raised the risk of DHF incidence (OR 3.169; 95% CI: 1.690-5.944) more than the low mobility. However, the DHF incidence was not correlated with moderate mobility (p=0,821). Furthermore, traveling outside the Yogyakarta Province reduced the risk by 6.175 times than non-traveling activity (p=0.000; OR 6.175; 95% CI: 2.759-13.822). Conclusion: The commuting mobility outside the village is a risk factor of DHF. Meanwhile, traveling outside Yogyakarta Province did not cause any risk for DHF and it instead tended to reduce the risk.

Long-term follow up of 57 patients undergoing automated percutaneous discectomy

1995 ◽  
Vol 83 (1) ◽  
pp. 31-33 ◽  
Author(s):  
Scott Shapiro
Keyword(s):  
Resonance Imaging ◽  
Chi Square ◽  
Content Type ◽  
Percutaneous Discectomy ◽  
Long Term Follow Up ◽  
The Mean ◽  
Chi Square Analysis ◽  
Lost To Follow Up

✓ Automated percutaneous discectomy has been performed in 57 patients at the author's institution since 1989, representing 4% of all lumbar spine surgeries. All 57 patients had unilateral sciatica. There were 33 women and 24 men ranging from 24 to 49 years of age, with a mean age of 45 years. All patients underwent computerized tomography (CT) in the prone position and CT and magnetic resonance imaging in the supine position. Diffuse versus eccentric disc bulging was determined for each patient. Four patients underwent surgery at the L3–4 level, four at L5–S1, and 49 at L4–5. One L5–S1 case could not be cannulated and surgery was aborted. There have been no complications related to surgery. Fifty patients (88%) stated they had reduced sciatica in the first 2 postoperative weeks. Forty (70%) had reduced sciatica 2 months postoperatively. The mean follow-up period was 27 months (range 6 to 45 months), with no patient lost to follow up. At their last follow-up examination, 33 patients (58%) showed improvement in their sciatica but only three (5%) were completely pain free. Of the 17 recurrences of sciatica, 11 patients have undergone microdiscectomy, with eight showing improvement. Chi-square analysis demonstrated a significantly better chance of improvement in patients with discs bulging eccentrically to the side of sciatica (p < 0.05) compared to patients with diffusely bulging discs. Automated percutaneous discectomy is safe and in selected patients can reduce sciatica, but only completely eliminated sciatica in 5% of patients with a follow-up period of 2.5 years.

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