Cold Sensitivity in Ulnar Neuropathy at the Elbow - Relation to Symptoms and Disability, Influence of Diabetes and Impact on Surgical Outcome

Cold sensitivity, an abnormal response to exposure to cold, is debilitating. It often affects people with nerve injuries and diabetes. Knowledge about the occurrence and prognostic impact of cold sensitivity in people with ulnar neuropathy at the elbow (UNE) is limited. We aimed to investigate the occurrence of cold sensitivity in UNE in relation to disability, the influence of diabetes and impact on surgical outcome. Data concerning 1270 persons operated on for UNE from 2010-2016 from the Swedish National Register for Hand Surgery (HAKIR) were matched with data from the Swedish National Diabetes Register (NDR). Disability and symptoms were assessed preoperatively, and at three and 12 months postoperatively using QuickDASH and a symptom-specific survey (HQ-8) containing one item regarding cold sensitivity. Differences regarding grade of cold sensitivity, occurrence of diabetes, QuickDASH scores and HQ-8 scores were studied. A linear regression analysis was performed to predict surgical outcome based on preoperative cold sensitivity. The mean age of the cases was 52 ± SD 14 years and 48% were women. Preoperatively, 427 answered the questionnaire. Severe cold sensitivity was present in 140/427 (33%) cases, moderate in 164/427 (38%) and mild in 123/427 (29%) cases. Cases with severe preoperative cold sensitivity reported higher QuickDASH scores at all times compared to cases with mild cold sensitivity. Relative change in QuickDASH scores over time did not differ between the groups. Cases with diabetes reported worse cold sensitivity preoperatively, but not postoperatively. All HQ-8 items improved with surgery, but cases with severe cold sensitivity reported worse persisting symptoms. Cold sensitivity is a major problem among those with UNE and an even greater preoperative problem among people with diabetes. It is associated with more symptoms and disability pre- and post-operatively. All cases, regardless of preoperative degree of cold sensitivity improve with surgery.

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Happiness, quality of working life, and job satisfaction among nurses working in emergency departments in Iran

Health and Quality of Life Outcomes ◽

10.1186/s12955-021-01755-3 ◽

2021 ◽

Vol 19 (1) ◽

Author(s):

Somayeh Javanmardnejad ◽

Razieh Bandari ◽

Majideh Heravi-Karimooi ◽

Nahid Rejeh ◽

Hamid Sharif Nia ◽

...

Keyword(s):

Job Satisfaction ◽

Emergency Departments ◽

Economic Status ◽

Linear Regression Analysis ◽

Working Life ◽

Least Square ◽

Life Questionnaire ◽

Quality Of Working Life ◽

The Mean

Abstract Background Nurses have a vital role in the healthcare system. One of the basic steps to increase their happiness is to recognize factors such as job satisfaction and quality of working life. Therefore, the goal of the present study was to examine the relationship between happiness and quality of working life and job satisfaction among nursing personnel. Methods This descriptive study was carried out on 270 hospital nurses who worked in emergency departments in Iran. Nurses were recruited through the census method. Data collection instruments included the Oxford Happiness Inventory (OHI), the Quality of Work Life Questionnaire (QWL), and the Job Satisfaction Questionnaire (JSQ). Data were explored using descriptive statistics, and stepwise multiple linear regression analysis. Results The mean age of participants was 30.1 ± 6.26 years. The mean happiness score was 38.5 ± 16.22, the mean Quality of Working Life (QWL) score was 84.3 ± 17.62, and the mean job satisfaction score was found to be 45.5 ± 13.57); corresponding to moderate levels of attributes. The results obtained from the ordinary least-square (OLS) regression indicated that happiness significantly was associated with economic status and satisfaction with closure (R2: 0.38). Conclusion Overall the current study found that nurses who work in emergency departments did not feel happy. Additionally, the findings suggest that their happiness were associated with their economic status, and closure over their duties.

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The impact of legs fat mass and legs lean fat mass on thigh circumference according cardiovascular risk: a population-based study

European Journal of Preventive Cardiology ◽

10.1093/eurjpc/zwab061.252 ◽

2021 ◽

Vol 28 (Supplement_1) ◽

Author(s):

M Chlabicz ◽

M Paniczko ◽

J Jamolkowski ◽

P Sowa ◽

M Lapinska ◽

...

Keyword(s):

Adipose Tissue ◽

Regression Analysis ◽

Linear Regression ◽

Muscle Tissue ◽

Fat Mass ◽

Linear Regression Analysis ◽

Population Based ◽

Thigh Circumference ◽

Tissue Model ◽

The Mean

Abstract Funding Acknowledgements Type of funding sources: Public Institution(s). Main funding source(s): Medical University of Bialystok, Poland Introduction A low thigh circumference is associated with an increased risk of high blood pressure, diabetes, cardiovascular diseases, and total mortality. Objectives The aim of the study was to investigate the relationship between the thigh circumference and cardiovascular (CV) risk classes, and to assess what type of tissue, adipose tissue or muscle tissue affects the thigh circumference. Methods The longitudinal, population-based, Polish study was conducted in 2017-2020. A total of 931 individuals aged 20-79 were analyzed. Pol-SCORE system was used to assess the 10-year risk of fatal CV based on the following risk factors: age, gender, smoking, systolic blood pressure, and total cholesterol for individuals aged 40-70. Then, CV risk classes were assessed using the 2019 ESC/EAS guidelines. The measurement of thigh circumference were performed directly below the gluteal fold of the thigh. Both thighs were measured and the mean value was calculated as the final thigh circumference. Body composition was assessed using Dual Energy X-ray Absorptiometry (DEXA). Results The mean age was 49.1 ± 15.5 years and 43.2% male. The mean thigh circumference was 58.2 ± 5.9 cm, the mean legs fat mass was 7.7 ± 2.8kg, and the mean legs lean mass was 16.9 ± 4.0kg. Lower thigh circumference was associated with higher CV risk classes in univariate linear regression analysis (β -0.516, p = 0.002), as well adjusted by age and sex (β -0.839, p = 0.008), adjusted by age, sex, BMI (β -0.886, p <0.001), and age, sex, WHR (β -0.988, p <0.001). In linear regression analysis legs adipose tissue and muscle tissue were related to the thigh circumference independently of CV risk classes (Model 1) and Pol-SCORE value (Model 2). However, fatty tissue (Model 1: β 0.746, p < 0.001; Model 2: β 0.749, p < 0.001) affects the thigh circumference more than the muscle tissue (Model 1: β 0.479, p < 0.001; Model 2: β 0.442, p < 0.001) (Fig. 1). Conclusion Smaller thigh circumference was associated with higher CV risk classes. Thigh circumference was more influenced by adipose tissue than by muscle tissue, regardless of the Pol-SCORE or CV risk classes. Table 1. Variable Model 1 Model 2 Beta p R2 Beta p R2 Legs fat mass 0.746 <0.001 0.785 0.749 <0.001 0.760 Legs lean mass 0.479 <0.001 0.785 0.442 <0.001 0.760 Model 1: adjusted for Cardiovascular risk classesModel 2: adjusted for Pol-SCOREResults of the linear regression analysis thigh circumference in the general population Abstract Figure 1.

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Non-invasive determination of the systolic peak-to-peak gradient in children with aortic stenosis: validation of a mathematical model

Cardiology in the Young ◽

10.1017/s1047951100006569 ◽

2000 ◽

Vol 10 (2) ◽

pp. 115-119 ◽

Cited By ~ 13

Author(s):

Valter C. Lima ◽

Evan Zahn ◽

Christine Houde ◽

Jeffrey Smallhorn ◽

Robert M. Freedom ◽

...

Keyword(s):

Mathematical Model ◽

Pulse Pressure ◽

Linear Regression Analysis ◽

Systolic Pressure ◽

Pressure Gradients ◽

Non Invasive ◽

The Mean ◽

Congenital Aortic Valvar Stenosis ◽

Peak Gradient

AbstractDoppler derived systolic pressure gradients have become widely applied as noninvasively obtained estimates of the severity of aortic valvar stenosis. There is little correlation, however, between the Doppler derived peak instantaneous gradient and the peak-to-peak gradient obtained at catheterisation, the latter being the most applied variable to determine severity in children. The purpose of this study was to validate a mathematical model based on data from catheterisation which estimates the peak-to-peak gradient from variables which can be obtained by noninvasive means (Doppler derived mean gradient and pulse pressure), according to the formula: peak-to-peak systolic gradient=6.02+1.49*(mean gradient)−0.44*(pulse pressure). Simultaneous cardiac catheterization and Doppler studies were performed on 10 patients with congenital aortic valvar stenosis. Correlations between the gradients measured at catheter measured, and those derived by Doppler, were performed using linear regression analysis. The mean gradients correlated well (y=0.67 × + 11.11, r=0.87, SEE=6 mm Hg, p=0.001). The gradients predicted by the formula also correlated well with the peak-to-peak gradients measured at catheter (y=0.66 × + 14.44, r=0.84, SEE=9 mm Hg, p=O.002). The data support the application of the model, allowing noninvasive prediction of the peak-to-peak gradient across the aortic valvar stenosis.

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How landscape and climate affect the spatial variability of the Italian rainfall extremes? Some initial clues based on I2-RED

10.5194/egusphere-egu21-7159 ◽

2021 ◽

Author(s):

Paola Mazzoglio ◽

Ilaria Butera ◽

Pierluigi Claps

Keyword(s):

Spatial Variability ◽

Linear Regression Analysis ◽

Alpine Region ◽

Annual Rainfall ◽

Mean Values ◽

Rainfall Extremes ◽

Geomorphological Parameters ◽

The Mean ◽

The Relationship ◽

Italian Territory

The intensity and the spatial distribution of precipitation depths are known to be highly dependent on relief and geomorphological parameters. Complex environments like mountainous regions are prone to intense and frequent precipitation events, especially if located near the coastline. Although the link between the mean annual rainfall and geomorphological parameters has received substantial attention, few literature studies investigate the relationship between the sub-daily maximum annual rainfall depth and geographical or morphological landscape features. In this study, the mean of the rainfall extremes in Italy, recently revised in the so-called I2-RED dataset, are investigated in their spatial variability in comparison with some landscape and also some broad climatic characteristics. The database includes all sub-daily rainfall extremes recorded in Italy from 1916 until 2019 and this analysis considers their mean values (from 1 to 24 hours) in stations with at least 10 years of records, involving more than 3700 stations. The geo-morpho-climatic factors considered range from latitude, longitude and minimum distance from the coastline on the geographic side, to elevation, slope, openness and obstruction morphological indices, and also include an often-neglected robust climatological information, as the local mean annual rainfall. Obtained results highlight that the relationship between the annual maximum rainfall depths and the hydro-geomorphological parameters is not univocal over the entire Italian territory and over different time intervals. Considering the whole of Italy, the highest correlation is reached between the mean values of the 24-hours records and the mean annual precipitation (correlation coefficient greater than 0.75). This predominance remains also in sub-areas of the Italian territory (i.e., the Alpine region, the Apennines or the coastal areas) but correlation decreases as the time interval decreases, except for the Alpine region (0.73 for the 1-hour maximum). The other geomorphological parameters seem to act in conjunction, making it difficult to evaluate, with a simple linear regression analysis, their impact. As an example, the absolute value of the correlation coefficient between the elevation and the 1-hour extremes is greater than 0.35 for the Italian and the Alpine regions, while for the 24-hours interval it is greater than 0.35 over the coastal areas. To further investigate the spatial variability of the relationship between rainfall and elevation, a spatial linear regression analysis has been undertaken. Local linear relationships have been fitted in circles centered on any of the 0.5-km size pixels in Italy, with 1 to 30 km radius and at least 5 stations included. Results indicate the need of more comprehensive terrain analysis to better understand the causes of local increasing or decreasing relations, poorly described in the available literature.

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Reduced oxygenation but not fibrosis defined by functional magnetic resonance imaging predicts the long-term progression of chronic kidney disease

Nephrology Dialysis Transplantation ◽

10.1093/ndt/gfy324 ◽

2018 ◽

Vol 35 (6) ◽

pp. 964-970 ◽

Cited By ~ 11

Author(s):

Kei Sugiyama ◽

Tsutomu Inoue ◽

Eito Kozawa ◽

Masahiro Ishikawa ◽

Akira Shimada ◽

...

Keyword(s):

Magnetic Resonance Imaging ◽

Chronic Kidney Disease ◽

Regression Analysis ◽

Linear Regression Analysis ◽

Resonance Imaging ◽

Bold Mri ◽

Adc Values ◽

The Mean ◽

Rate Of Decline ◽

Observation Period

Abstract Background Although chronic hypoxia and fibrosis may be a key to the progression of chronic kidney disease (CKD), a noninvasive means of measuring these variables is not yet available. Here, using blood oxygen level–dependent (BOLD) and diffusion-weighted (DW) magnetic resonance imaging (MRI), we assessed changes in renal tissue oxygenation and fibrosis, respectively, and evaluated their correlation with prognosis for renal function. Methods The study was conducted under a single-center, longitudinal, retrospective observational design. We examined the prognostic significance of T2* values of BOLD-MRI and apparent diffusion coefficient (ADC) values on DW-MRI and other clinical parameters. The rate of decline in estimated glomerular filtration rate (eGFR) was calculated by linear regression analysis using changes in eGFR during the observation period. Results A total of 91 patients were enrolled, with a mean age of 55.8 ± 15.6 years. Among patients, 51 (56.0%) were males and 38 (41.8%) had diabetes mellitus. The mean eGFR was 49.2 ± 28.9 mL/min/1.73 m2 and the mean observation period was 5.13 years. ADC values of DW-MRI but not T2* values of BOLD-MRI were well correlated with eGFR at the initial time point. The mean annual rate of decline in eGFR during the 5-year observation period was −1.92 ± 3.00 mL/min/1.73 m2. On multiple linear regression analysis, the rate of decline in eGFR was significantly correlated with eGFR at the start point, period average amount of proteinuria and T2* values, but not with ADC values (t = 2.980, P = 0.004). Conclusions Reduced oxygenation as determined by low T2* values on BOLD-MRI is a clinically useful marker of CKD progression.

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Bioelectrical Impedance Analysis of Water Reduction in Lower-Limb Lymphedema by Lymphaticovenular Anastomosis

Journal of Reconstructive Microsurgery ◽

10.1055/s-0038-1675368 ◽

2018 ◽

Vol 35 (04) ◽

pp. 306-314 ◽

Cited By ~ 3

Author(s):

Yoshichika Yasunaga ◽

Daisuke Yanagisawa ◽

Erika Ohata ◽

Kiyoshi Matsuo ◽

Shunsuke Yuzuriha

Keyword(s):

Lower Limb ◽

Bioelectrical Impedance Analysis ◽

Linear Regression Analysis ◽

Reduction Rate ◽

Bioelectrical Impedance ◽

Impedance Analysis ◽

Body Water ◽

Volume Reduction ◽

Water Volume ◽

The Mean

Background Although lymphedema is fundamentally abnormal accumulation of excess water in the extracellular space, previous studies have evaluated the efficacy of physiological bypass surgery (lymphaticovenular anastomosis [LVA]) for lymphedema without measuring water volume. This study clarified the water reductive effect of LVA using bioelectrical impedance analysis (BIA). Methods The efficacy of LVA for unilateral lower-limb lymphedema was evaluated using BIA in a retrospective cohort. The water volume of affected and unaffected legs was measured using multifrequency BIA before and after LVA. Preoperative measurements were undertaken after compression therapy for at least 3 months. The follow-up period after LVA was a minimum of 6 months. Results Thirty consecutive patients with unilateral lower-limb lymphedema were enrolled. The mean water volume reduction of the affected leg by LVA (ΔLBW) was 0.86 L (standard deviation [SD]: 0.86, median: 0.65) with a mean number of 3.3 anastomoses (SD: 1.7). The mean reduction rate of edema was 45.1% (SD: 36.3). Multiple linear regression analysis revealed water volume difference between the affected and unaffected legs before LVA (excess LBW) as the strongest predictor of ΔLBW (R 2 = 0.759, p < 0.01; β = 0.500, p < 0.01). Conclusion The LVA reduces the volume of accumulated body water in lower-limb lymphedema. As excess LBW most strongly predicted the amount of water volume reduction by LVA, body water volume measurement by BIA before LVA might identify patients with low excess LBW not expected to benefit from LVA, regardless of apparent differences in limb circumference.

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Is Allograft Reconstruction of the Medial Ulnar Collateral Ligament of the Elbow a Viable Option for Nonelite Athletes? Outcomes at a Mean of 8 Years

Orthopaedic Journal of Sports Medicine ◽

10.1177/2325967120959141 ◽

2020 ◽

Vol 8 (10) ◽

pp. 232596712095914

Author(s):

Justin C. Kennon ◽

Erick M. Marigi ◽

Chad E. Songy ◽

Chris Bernard ◽

Shawn W. O’Driscoll ◽

...

Keyword(s):

Clinical Outcomes ◽

Case Series ◽

Ulnar Collateral Ligament ◽

Ulnar Neuropathy ◽

Complication Rates ◽

Collateral Ligament ◽

Level Of Evidence ◽

Functional Scores ◽

The Mean

Background: The rate of elbow medial ulnar collateral ligament (MUCL) injury and surgery continues to rise steadily. While authors have failed to reach a consensus on the optimal graft or anchor configuration for MUCL reconstruction, the vast majority of the literature is focused on the young, elite athlete population utilizing autograft. These studies may not be as applicable for the “weekend warrior” type of patient or for young kids playing on high school leagues or recreationally without the intent or aspiration to participate at an elite level. Purpose: To investigate the clinical outcomes and complication rates of MUCL reconstruction utilizing only allograft sources in nonelite athletes. Study Design: Case series; Level of evidence, 4. Methods: Patient records were retrospectively analyzed for individuals who underwent allograft MUCL reconstruction at a single institution between 2000 and 2016. A total of 25 patients met inclusion criteria as laborers or nonelite (not collegiate or professional) athletes with a minimum of 2 years of postoperative follow-up. A review of the medical records for the included patients was performed to determine survivorship free of reoperation, complications, and clinical outcomes with use of the Summary Outcome Determination (SOD) and Timmerman-Andrews scores. Statistical analysis included a Wilcoxon rank-sum test to compare continuous variables between groups with an alpha level set at .05 for significance. Subgroup analysis included comparing outcome scores based on the allograft type used. Results: Twenty-five patients met all inclusion and exclusion criteria. The mean time to follow-up was 91 months (range, 25-195 months), and the mean age at the time of surgery was 25 years (range, 12-65 years). There were no revision operations for recurrent instability. The mean SOD score was 9 (range, 5-10) at the most recent follow-up, and the Timmerman-Andrews scores averaged 97 (range, 80-100). Three patients underwent subsequent surgical procedures for ulnar neuropathy (n = 2) and contracture (n = 1), and 1 patient underwent surgical intervention for combined ulnar neuropathy and contracture. Conclusion: Allograft MUCL reconstruction in nonelite athletes demonstrates comparable functional scores with many previously reported autograft outcomes in elite athletes. These results may be informative for elbow surgeons who wish to avoid autograft morbidity in common laborers and nonelite athletes with MUCL incompetency.

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OCT-Angiography Findings in Patients with Amblyopia: Comparison between Healthy Controls, Treatment-Responsive, and Treatment-Unresponsive Amblyopic Patients

Diagnostics ◽

10.3390/diagnostics11101751 ◽

2021 ◽

Vol 11 (10) ◽

pp. 1751

Author(s):

Annabella Salerni ◽

Gloria Gambini ◽

Chiara Fedeli ◽

Ludovica Paris ◽

Emanuele Crincoli ◽

...

Keyword(s):

Linear Regression Analysis ◽

Vascular Density ◽

Ocular Motility ◽

Ophthalmological Examination ◽

Light Stimulation ◽

Cross Sectional ◽

Vascular Plexus ◽

The Mean ◽

Normal Controls ◽

Expert Physician

There is no consensus on whether amblyopia affects the retinal vascular plexus and morphology. Previous studies focused on the differences between amblyopic patients and normal controls without evaluating amblyopic eyes after patching. To evaluate differences in the superficial vascular density of amblyopic eyes, normal eyes, and amblyopic eyes reaching normal BCVA after patch therapy, OCTA was used. All patients underwent a comprehensive ophthalmological examination, including visual acuity, refraction, ocular motility tests, and anterior and posterior segment examination. OCTA was performed by an expert physician using the Zeiss Cirrus 5000-HD-OCT Angioplex (Carl Zeiss, Meditec, Inc., Dublin, OH, USA). OCTA scans were performed using a 3 × 3 mm2 and 6 × 6 mm2 fovea-centered image setting. The mean outer macular vessel density in the previously amblyopic group was 19.15 ± 0.51%. This was statistically significantly higher than in both the amblyopic group (18.70 ± 1.14%) and the normal controls (18.18 ± 1.40%) (p = 0.014). The previously amblyopic group also significantly differed from both normal controls and amblyopic eyes with regards to the inner (p = 0.011), outer (p = 0.006), and full (p = 0.003) macular perfusion. Finally, linear regression analysis revealed that BCVA was linearly correlated to outer perfusion in amblyopic (p = 0.003) and ex amblyopic eyes (p < 0.001). Considering the cross-sectional nature of our study, from our results, we can only hypothesize a possible correlation between light stimulation and retinal vasculature development. However, further longitudinal studies are needed to support this hypothesis.

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Positive patient experience of wide awake local anaesthesia no tourniquet (WALANT) hand surgery in the government setting: a prospective descriptive study

SA Orthopaedic Journal ◽

10.17159/2309-8309/2021/v20n3a1 ◽

2021 ◽

Vol 20 (3) ◽

Author(s):

Jaco J Naude ◽

Odette Koch ◽

Ludwig W Schmidt ◽

Theo LB le Roux

Keyword(s):

Patient Experience ◽

Carpal Tunnel ◽

Local Anaesthesia ◽

Surgical Procedure ◽

Hand Surgery ◽

Descriptive Study ◽

Trigger Finger ◽

The Mean ◽

Wide Awake ◽

No Tourniquet

ABSTRACT BACKGROUND: The purpose of this study was to establish a subjective patient experience with wide awake local anaesthesia no tourniquet (WALANT) procedures performed in the institution from May 2019 to March 2020. WALANT surgery was initiated to improve standard operating procedure and to decrease theatre burden METHODS: This prospective, descriptive study included 100 patients with a mean age of 59 years who required either a carpal tunnel or trigger finger release. The patients' pain experience was documented on the visual analogue scale (VAS) for the local anaesthetic injection and the surgical procedure. Overall experience was assessed on the patient's preference to have the procedure performed by the WALANT method or the conventional method RESULTS: One hundred patients were included, of which 67 had medical comorbidities. The mean VAS score was 1.5 (SD±1.6) with pain on injection. The mean VAS pain score during the surgical procedure was 0.2 (SD±0.7). One hundred per cent of patients (100/100) felt they would do the WALANT outpatient procedure again instead of admission to hospital and surgery in the theatre. Two complications occurred related to wound care problems, and were successfully managed. None of the patients required reoperations for incomplete release of the carpal tunnel or trigger finger surgery CONCLUSION: The results of this study suggest that minor hand surgery using the WALANT protocol can be performed effectively and with high patient satisfaction rates in the orthopaedic outpatient clinic, and is a useful tool in the skillset of a hand surgeon Level of evidence: Level 4 Keywords: WALANT, hand surgery, trigger finger, carpal tunnel release

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Haglund’s disease: surgical outcome of calcaneal osteotomy

International Journal of Research in Orthopaedics ◽

10.18203/issn.2455-4510.intjresorthop20170786 ◽

2017 ◽

Vol 3 (2) ◽

pp. 278 ◽

Cited By ~ 1

Author(s):

Veerabhadra Javali ◽

Virupaksha N. Reddy

Keyword(s):

Conservative Treatment ◽

Surgical Outcome ◽

Surgical Intervention ◽

Lateral Approach ◽

Lateral View ◽

Aofas Score ◽

Postoperative Score ◽

Calcaneal Osteotomy ◽

The Mean

Background: The aim of the present study was to assess the surgical outcome of Haglund’s disease by calcaneal osteotomy.Methods: 23 cases of Haglund’s disease who failed to respond to conservative treatment were considered for surgery. Parallel pitch lines were drawn in the lateral view radiograph of the calcaneum and the bursal projection to be resected was assessed. All cases were surgically treated with calcaneal osteotomy through lateral approach and followed.Results: 23 cases of Haglund’s disease were treated with this procedure and 21 were available for follow up. The mean follow-up was 15 months. The mean preoperative AOFAS score of 60.57 points (SD= 3.23) and postoperative score of 88.71 points (SD= 3.92) was obtained. Three minor complications were noted. Conclusions: The results of the current study suggest that calcaneal ostectomy produces outcomes that justify surgical intervention in cases of Haglund’s disease.

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