Treatment of slipped capital femoral epiphysis - a comparative study during twelve years period

Introduction/Objective. The purpose of this study was to compare two methods of treatment and to evaluate the advantages in the final outcome of transcervical fixation of the femoral head using one cannulated screw in the treatment of slipped capital femoral epiphysis. Methods. This study included 65 pediatric patients (35 boys and 30 girls), aged 6?16 years (average 11.86), during a 12-year period (2000?2012). We compared the slipping degree before and after the treatment (Southwick angle), the range of motion before and after treatment, and complication occurrence between two groups of children. The first group of children (26 patients) underwent closed reduction and cast immobilization (Group I). The other group (39 patients) was treated with transcervical fixation using one cannulated screw (Group II). Results. Comparing preoperative and postoperative Southwick angle, we found much better improvement in Group II, but without statistical significance between the two groups of patients (p = 0.09). Observing the range of motion of the hips before and after treatment, we found improvement in both groups of patients, especially in patients treated using transcervical fixation with cannulated screw (Group II). In complication occurrence, the patients in Group II had less complication occurrence compared to Group I (p = 0.02). Conclusion. The transcervical fixation using one cannulated screw has better clinical outcome and lower complication rate in relation to closed reduction and cast immobilization in the treatment of slipped capital femoral epiphysis.

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Management of Pediatric Displaced Distal Metaphyseal Forearm Fracture: Comparison between Cast Immobilization and Percutaneous Kirschner Wire Fixation

Nepal Orthopaedic Association Journal ◽

10.3126/noaj.v2i1.8133 ◽

2013 ◽

Vol 2 (1) ◽

pp. 1-6

Author(s):

D Shrestha ◽

D Dhoju ◽

N Parajuli ◽

G Dhakal ◽

R Shrestha

Keyword(s):

Clinical Outcomes ◽

Closed Reduction ◽

Forearm Fracture ◽

Kirschner Wire ◽

Cast Immobilization ◽

Kirschner Wire Fixation ◽

Group I ◽

Alternative Treatment Option ◽

Wire Fixation ◽

Group Ii

Background: Distal metaphyseal forearm fracture is one of the common injuries in children. Closed reduction and above elbow cast is the standard method of treatment but reported to be associated with redisplacement rate of 7-25%. Closed reduction and fixation with percutaneous Kirschner wire is an alternative treatment option to prevent redisplacement. Methods: Thirty five children (group I) of age between 6 to 13 yrs with displaced ( more than 50% of cortical diameter) or angulated (more than 20°) distal metaphyseal forearm fracture managed with closed reduction and above elbow cast were compared with 21 children (group II) managed with closed reduction and percutaneous crossed Kirschner fixation. Clinical outcomes and complications were compared in both groups after 12 weeks of follow up. Results: Preoperative variables in both the groups were comparable. Mean loss of elbow flexion and extension (12° vs. 4°, p =0.08), wrist dorsflexion and palmerflexion (27° vs. 14°, p=0.12) and forearm supination and pronation (27° vs. 15°, p= 0.143) were more in group I but were statistically not significant. Complications rate (28.4% vs. 19.04%, p= 0.04) was higher in group I (such as fracture redisplacement and swelling) than in group II (pin tract infection). Conclusions: Grossly displaced or angulated distal metaphyseal forearm both bone fracture in children treated with either closed reduction and above elbow cast or closed reduction with crossed Kirschner wire fixation have no statistically significant clinical outcomes in terms of loss of movement of elbow, wrist and forearm but complication rate is higher in cast group. Percutaneous Kirschner wire fixation prevents redisplacement. DOI: http://dx.doi.org/10.3126/noaj.v2i1.8133 Nepal Orthopaedic Association Journal Vol.2(1) 2011: 1-6

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Intrastromal corneal ring segment implantation in paracentral keratoconus with perpendicular topographic astigmatism and comatic axis

European Journal of Ophthalmology ◽

10.1177/1120672120952346 ◽

2020 ◽

pp. 112067212095234

Author(s):

Luis Fernández-Vega-Cueto ◽

Carlos Lisa ◽

Belén Alfonso-Bartolozzi ◽

David Madrid-Costa ◽

José F Alfonso

Keyword(s):

Statistical Significance ◽

Arc Length ◽

Refractive Outcomes ◽

Group I ◽

Intrastromal Corneal Ring ◽

Before And After ◽

Ring Segment ◽

Group Ii ◽

Topographic Astigmatism

Purpose: To evaluate the outcomes of implanting intrastromal corneal ring segment (ICRS) using two different strategies in a specific paracentral keratoconus phenotype. Methods: Eighty-nine eyes with paracentral keratoconus with perpendicular topographic astigmatism and comatic axes were evaluated before and after implanting a 150° arc-length ICRS. Patients were divided into two groups according to the axis where the ICRS was implanted: Group I: comatic axis and Group II: flat topographic axis. Uncorrected (UDVA) and corrected (CDVA) distance visual acuities, refractive errors, and root mean square (RMS) for coma-like aberration were recorded. The postoperative follow-up was 1 year. Results: Mean UDVA (logMAR) changed from 0.49 ± 0.37 preoperatively to 0.30 ± 0.32 6 months afterwards ( p < 0.001) in the group I and from 0.53 ± 0.34 to 0.37 ± 0.35 ( p < 0.001), in the group II. Mean CDVA in group I changed from 0.11 ± 0.18 preoperatively to 0.06 ± 0.14 6 months after surgery ( p < 0.001). In group II the improvement did not reach statistical significance (from 0.09 ± 0.10 to 0.07 ± 0.09; p = 0.06). No eyes lost lines of CDVA in group I. Eight eyes (15.7%) lost lines of CDVA in group II. The spherical equivalent decreased after surgery in both groups ( p < 0.001). The RMS for corneal coma-like aberration only decreased in the group I ( p < 0.001). Conclusion: Both strategies provided safe and effective visual and refractive outcomes in the specific keratoconus phenotype analyzed. The orthopedic strategy provided better visual outcomes than the refractive one.

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Comparison of a PGA Sheet with a Commercial ePTFE Sheet as a Staple-Line Reinforcement in Lung Surgery

Key Engineering Materials ◽

10.4028/www.scientific.net/kem.342-343.849 ◽

2007 ◽

Vol 342-343 ◽

pp. 849-852

Author(s):

Keon Hyeon Jo ◽

Seok Whan Moon ◽

Young Du Kim ◽

Young Jo Sa ◽

Si Young Choi ◽

...

Keyword(s):

Statistical Significance ◽

Polyglycolic Acid ◽

Lung Surgery ◽

Resection Margins ◽

Air Leakage ◽

Staple Line Reinforcement ◽

Group I ◽

Significant Difference ◽

Similar Threshold ◽

Group Ii

To prevent prolonged air leakage after lung surgery, we developed a biodegradable polyglycolic acid (PGA) sheet and compared it with an expanded polytetrafluoethylene (ePTFE). Eighteen adult mongrel dogs were used in this experiment. The airway pressures at which air first leaked at the stapled resection margins were measured immediately after surgery in group I (N=5), 2 days after surgery in group II (N=5), and 7 days after surgery in group IIII (N=5), Based on the presence of SLR, there were 3 subgroups in each group: there was no SLR in subgroup a; ePTFE in subgroup b; PGA sheet in subgroup c. The histologic examination was performed 2 months after surgery (N=3). In group I, there was a significant difference in air leakage pressures (mm Hg) between no reinforcement and SLR. We observed the same results in group II and III with statistical significance. However, there was no significant difference between the reinforcement groups. The histologic findings demonstrated more severe adhesions and biodegradation in the dogs in which the PGA sheet was used. Our PGA sheet was considered a useful reinforcement material, because it had a similar threshold for air leakage with the ePTFE with excellent biodegradation.

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Endothelin effects in isolated, perfused lamb lungs: role of cyclooxygenase inhibition and vasomotor tone

AJP Heart and Circulatory Physiology ◽

10.1152/ajpheart.1991.261.2.h443 ◽

1991 ◽

Vol 261 (2) ◽

pp. H443-H450 ◽

Cited By ~ 2

Author(s):

H. Toga ◽

J. Usha Raj ◽

R. Hillyard ◽

B. Ku ◽

J. Anderson

Keyword(s):

Vasomotor Tone ◽

Cyclooxygenase Inhibition ◽

Group Iii ◽

Group I ◽

Before And After ◽

Pulmonary Arterial ◽

Group Ii ◽

Sites Of Action ◽

Arteries And Veins

We have determined the sites of action of endothelin-1 (ET) in the lamb pulmonary circulation. The influence of cyclooxygenase inhibition and baseline vasomotor tone on ET effects was also studied. Lungs of 14 lambs (6-9 wk of age, 12.1 +/- 0.6 kg body wt) were isolated and perfused with blood. Group I lungs (n = 5) were untreated, group II lungs (n = 5) were treated with indomethacin to inhibit cyclooxygenase, and group III lungs (n = 4) were treated with indomethacin and a thromboxane A2 analogue, U-46619, to elevate vasomotor tone. All lungs were perfused with constant flow in zone 3, with left atrial and airway pressures being 8 and 6 cmH2O, respectively. We measured pulmonary arterial pressure and, by the micropuncture servo-null method, pressures in 20- to 50-microns diameter subpleural venules, both before and after each dose of ET was infused (50, 100, 250, and 500 ng/kg). Group I lungs, with high baseline vasomotor tone, exhibited a biphasic response to ET; 50-100 ng/kg of ET dilated both arteries and veins, whereas 500 ng/kg of ET constricted both arteries and veins. In group II lungs with low vasomotor tone, all doses of ET caused constriction of arteries only. In group III lungs (indomethacin treated with elevated vasomotor tone), 50-100 ng/kg of ET caused dilation of arteries and veins, whereas 500 ng/kg of ET induced constriction, this time only in arteries. We conclude that ET has both dilator and constrictor effects in arteries and veins of isolated, perfused lamb lungs. ET-induced arterial and venous dilation is dependent on initial vasomotor tone but not on cyclooxygenase metabolites.(ABSTRACT TRUNCATED AT 250 WORDS)

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Effect of Virtual Reality‐Based Rehabilitation on Physical Fitness in Patients with Chronic Obstructive Pulmonary Disease

Journal of Human Kinetics ◽

10.2478/hukin-2019-0022 ◽

2019 ◽

Vol 69 (1) ◽

pp. 149-157 ◽

Cited By ~ 3

Author(s):

Sebastian Rutkowski ◽

Anna Rutkowska ◽

Dariusz Jastrzębski ◽

Henryk Racheniuk ◽

Witold Pawełczyk ◽

...

Keyword(s):

Chronic Obstructive Pulmonary Disease ◽

Virtual Reality ◽

Physical Fitness ◽

Pulmonary Disease ◽

Training Group ◽

Chronic Obstructive ◽

Obstructive Pulmonary Disease ◽

Group I ◽

Before And After ◽

Group Ii

Abstract The aim of the study was to evaluate the effects of rehabilitation in patients with chronic obstructive pulmonary disease (COPD) using the Kinect system during stationary rehabilitation. The study included 68 patients with COPD (35 men, 33 women, mean age 61.3 ± 3.7). The subjects were randomly assigned to one of the two experimental groups described below. Group I included 34 patients – non‐participants in Kinect training. Group II included 34 patients – participants in Kinect training. In all patients before and after rehabilitation physical fitness was assessed using the Senior Fitness Test (SFT). The Xbox 360 and Kinect motion sensor were used to carry out virtual reality training. In group I, statistically significant improvements in SFT performance were observed. Patients in group II also showed statistically significant improvement in physical fitness in all attempts of the SFT. Virtual rehabilitation training in patients with COPD seems to be a practical and beneficial intervention capable of enhancing mobility and physical fitness.

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Binocular responses and vertical strabismus

Vojnosanitetski pregled ◽

10.2298/vsp0702109r ◽

2007 ◽

Vol 64 (2) ◽

pp. 109-115 ◽

Cited By ~ 1

Author(s):

Dusica Risovic ◽

Lidija Petrovic ◽

Natalija Kosanovic-Jakovic ◽

Katarina Misailovic ◽

Branislav Stankovic ◽

...

Keyword(s):

Binocular Vision ◽

Oblique Muscle ◽

Common Pattern ◽

Inferior Oblique Muscle ◽

Group I ◽

Significant Difference ◽

Before And After ◽

Group Ii ◽

Sensory Tests ◽

Dissociated Vertical Deviation

Background/Aim. Elevation in adduction is the most common pattern of vertical strabismus, and it is mostly treated with surgery. The results of weaking of inferior oblique muscle are very changeable. The aim of this study was to evaluate binocular vision using sensory tests before and one and six months after the surgery. Methods. A total of 79 children were divided in two groups: the first, with inferior oblique muscle of overaction (n = 52), and the second with dissociated vertical deviation (DVD), and primary inferior oblique muscle overaction (n = 27). We tested them by polaroid mirror test (PMT), Worth test at distance and near, fusion amplitudes on sinoptofore, Lang I stereo test and Wirt-Titmus stereo test. We examined our patients before and two times after the surgery for vertical strabismus. Results. Foveal suppression in the group I was found in 60.5% of the patients before, and in 56.4% after the surgery. In group II Foveal suppression was detected in 64.7% of the patients before, but in 55.6% 6 months after the surgery with PMT. Worth test revealed suppression in 23.5% of the patients before, and in 40.7% after the vertical muscle surgery. Parafoveal fussion persisted in about 1/3 of the patients before the surgery, and their amplitudes were a little larger after the surgery in the group I patients. Lang I stereo test was negative in 53.9% before and 51.9% after the surgery in the group I, and in 48.2% of the patients before and after the surgery in the group II patients. Wirt-Titmus stereo test was negative in 74.5% of the patients before and in 72.9% after the surgery in the group I, but in the group II it was negative in 70.8% before and in 68.0% of the patients 6 months after the surgery. Conclusion. Binocular responses were found after surgery in 65.7% of the patients the group I and in 55.6% patients the group II. There was no significant difference between these two groups, but binocular responses were more often in the patients of the group I.

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Ventilation and thoracoabdominal asynchrony during halothane anesthesia in infants

Journal of Applied Physiology ◽

10.1152/jappl.1993.74.4.1591 ◽

1993 ◽

Vol 74 (4) ◽

pp. 1591-1596 ◽

Cited By ~ 22

Author(s):

M. Benameur ◽

M. D. Goldman ◽

C. Ecoffey ◽

C. Gaultier

Keyword(s):

Tidal Volume ◽

Minute Ventilation ◽

Statistical Significance ◽

Age Group ◽

Halothane Anesthesia ◽

Minimal Alveolar Concentration ◽

Group I ◽

Wall Compliance ◽

Group Ii ◽

Thoracoabdominal Asynchrony

To evaluate the ventilatory consequences of high chest wall compliance during anesthesia in infants, we assessed the effects of halothane at different fractions of minimal alveolar concentration (0.75, 1.0, and 1.5 MAC) on ventilation and movements of the rib cage and abdomen in infants < or = 12 mo of age (group I) and children (group II) > or = 12 mo of age. Minute ventilation decreased in group I, (20.6%, 0.75 to 1.5 MAC), but the change in group II did not reach the level of statistical significance. Tidal volume decreased with halothane level between 0.75 and 1.5 MAC, and its fall was greater in group I (32.7 +/- 11.2 vs. 22.6 +/- 9.3% in group II, P < 0.05). Duty cycle, or ratio of inspiratory to total time (TI/TT), increased in group II with halothane level but did not change in group I, resulting in a decreased TI in group I at higher halothane levels. Thoracic paradox increased with halothane level in group I but not group II. The increase in thoracic paradox in association with the fall in tidal volume between 0.75 and 1.5 MAC was greater in group I than group II (P < 0.05). We conclude that smaller infants depend more on inspiratory intercostal muscle activity to stabilize the thorax, leading to a greater degree of depression of ventilation during halothane depression of inspiratory intercostal activity.

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THE COMPARISON OF DEEP NECK FLEXOR STRENGTHENING EXERICISE WITH MCKENZIE NECK EXERCISE FOR NECK POSTURE CORRECTION ON STUDENTS WITH FORWARD HEAD POSTURE AT SMA N 1 SEMARAPURA

Majalah Ilmiah Fisioterapi Indonesia ◽

10.24843/mifi.2018.v06.i01.p09 ◽

2018 ◽

Vol 6 (1) ◽

pp. 23

Author(s):

Gede Eka Juli Prasana ◽

I Nyoman Adiputra ◽

I Made Krisna Dinata

Keyword(s):

Exercise Intervention ◽

Hypothesis Test ◽

Test Group ◽

Forward Head Posture ◽

Head Posture ◽

Group I ◽

Strengthening Exercise ◽

Significant Difference ◽

Before And After ◽

Group Ii

This study aims to compare deep neck flexor strengthening exercise intervention with mckenzie neck exercise to correct the neck posture of student with forward head posture. Using experimental design with Pre-Test and Post-Test Group Design involves a sample of 24 people divided into 2 groups. Group I was given deep neck flexor strengthening exercise intervention and Group II was given mckenzie neck exercise intervention. Hypothesis Test using paired sample t-test obtained result p = 0.592 with average difference in Group I 7.58 ± 4.39 whereas Group II got difference mean 8.5 ± 3.84. These results showed no significant difference in craniovertebral angle elevation before and after intervention in both groups. Keywords : forward head posture, craniovertebrae angle, deep neck flexor strengthening exercise, mckenzie neckexercise,

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Different Bleeding Patterns with the Use of Levonorgestrel Intrauterine System: Are They Associated with Changes in Uterine Artery Blood Flow?

BioMed Research International ◽

10.1155/2014/815127 ◽

2014 ◽

Vol 2014 ◽

pp. 1-6 ◽

Cited By ~ 5

Author(s):

Carlo Bastianelli ◽

Manuela Farris ◽

Stefania Rapiti ◽

Roberta Bruno Vecchio ◽

Giuseppe Benagiano

Keyword(s):

Blood Flow ◽

Uterine Artery ◽

Endometrial Thickness ◽

Power Doppler ◽

Artery Blood Flow ◽

Group Iii ◽

Group I ◽

Significant Difference ◽

Before And After ◽

Group Ii

Objective. Evaluate if different bleeding patterns associated with the use of the levonorgestrel intrauterine system (LNG-IUS) are associated with different uterine and endometrial vascularization patterns, as evidenced by ultrasound power Doppler analysis.Methodology. A longitudinal study, with each subject acting as its own control was conducted between January 2010 and December 2012. Healthy volunteers with a history of heavy but cyclic and regular menstrual cycles were enrolled in the study. Ultrasonographic examination was performed before and after six months of LNG-IUS placement: uterine volume, endometrial thickness, and subendometrial and myometrial Doppler blood flow patterns have been evaluated.Results. A total of 32 women were enrolled out of 186 initially screened. At six months of follow-up, all subjects showed a reduction in menstrual blood loss; for analysis, they were retrospectively divided into 3 groups: normal cycling women (Group I), amenorrheic women (Group II), and women with prolonged bleedings (Group III). Intergroup analysis documented a statistically significant difference in endometrial thickness among the three groups; in addition, mean pulsatility index (PI) and resistance index (RI) in the spiral arteries were significantly lower in Group I and Group III compared to Group II. This difference persisted also when comparing—within subjects of Group III—mean PI and RI mean values before and after insertion.Conclusions. The LNG-IUS not only altered endometrial thickness, but—in women with prolonged bleedings—also significantly changed uterine artery blood flow. Further studies are needed to confirm these results and enable gynecologists to properly counsel women, improving initial continuation rates.

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Changes in Teat Morphology (Doka Phenomenon) and Estrus Prediction in Riverine Buffaloes (Bubalus bubalis)

Indian Journal of Animal Research ◽

10.18805/ijar.b-3517 ◽

2019 ◽

Author(s):

S K Joshi ◽

T K Mohanty ◽

A Kumaresan ◽

M Bhakat ◽

S Sathapathy

Keyword(s):

Morphological Changes ◽

Bubalus Bubalis ◽

North India ◽

Research Centre ◽

Murrah Buffaloes ◽

Group I ◽

Before And After ◽

Group Ii ◽

The Difference ◽

The Relationship

The objective of the study was to characterize the term Doka and to capture morphological changes in teat to find out the relationship between Doka and onset of estrus in Murrah buffaloes (Bubalus bubalis). The Murrah buffaloes maintained at of Livestock Research Centre (LRC), ICAR-NDRI, Karnal were classified into two groups based on the lactation number for the study of Doka characteristics. In group I, twenty animals up to 3rd lactation were incorporated, whereas thirty animals from 4th to 5th lactation were included in group II. The period when buffaloes showed teat engorgement was called as Doka period, is the local term used by the farmers in North India that can be taken as a visual sign for prediction of estrus. The length and diameter of teats, before and after milking were measured, for both the groups during morning and evening milking and subsequently analyzed. The present study confirmed that the teat diameter (mm) before milking during Doka was significantly (plessthan0.05) higher as compared to pre Doka period in both the groups (group-I - 37.01 ±2.13 vs 28.42 ±1.64, group-II - 53.49 ±2.82 vs 41.096±2.16). The teat diameter (mm) during Doka period after milking was significantly (plessthan0.05) more in both the groups (group-I - 26.65 ±1.26 vs 24.44 ±1.16, group-II - 39.27 ±2.41 vs 35.31 ±2.17) as compared to pre Doka period. So, it can be concluded that the changes in teat diameter can safely be considered as a sign of Doka and the forthcoming heat in Murrah buffaloes. However, the difference in teat length between different stages of Doka was found to be non significant.

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