scholarly journals Prevalence and Morphology of the Coracoclavicular Joint: An Osteological Study of 2,724 Subjects Using Univariable and Multivariable Logistic Regression Analyses

2021 ◽  
Vol 8 ◽  
Author(s):  
Ethan Robert Harlow ◽  
Lee M. Sasala ◽  
Christopher E. Talbot ◽  
Bijal J. Desai ◽  
Jason Ina ◽  
...  
Keyword(s):  
Logistic Regression ◽  
African Americans ◽  
Functional Limitations ◽  
Morphological Characteristics ◽  
Surgical Excision ◽  
Shoulder Abduction ◽  
Level Of Evidence ◽  
Caucasian Americans ◽  
Anterior Shoulder Pain ◽  
Coracoclavicular Joint

Background: The coracoclavicular joint (CCJ) is an anomalous articulation between the surfaces of the inferior clavicle and superior coracoid and its etiology is controversial. Reportedly, symptomatic patients demonstrate significant functional limitations including shoulder abduction loss and potential for brachial plexus compression and impingement.Purpose: To determine the prevalence of CCJ across age, gender and ethnicity, and to identify clinically useful morphological characteristics.Methods: 2,724 subjects with intact clavicles and scapulae from the Hamann-Todd Osteological Collection were evaluated for the presence of CCJ. Logistic regression was used to determine the effect of age, height, gender, and race on prevalence of CCJ. 354 clavicles with CCJ were measured for size and location of the CCJ facet.Results: CCJ was observed in 9% of subjects. CCJ was more prevalent in African-Americans (12%) than Caucasian-Americans (6%) (p < 0.001) and more prevalent in females (11%) than males (8%) (p = 0.055). Facet location along clavicle length was consistent (average 25%, range 15–35%). But, facet location along clavicle width varied (average 60%, range 10–90%), with males having a more posterior location. For every 10-year increase in age, facet elevation (p = 0.001) and surface area (p < 0.001) increased.Conclusions: CCJ prevalence was 9% in our large osseous population, found more commonly in African-Americans and females. Facet location is predictable with respect to clavicle length, but less so along clavicle width. The clavicular facet may develop at some point in life and continue to grow in size after its appearance.Clinical Relevance: Presence of a CCJ represents a potential overlooked source of anterior shoulder pain and supracoracoid impingement. Epidemiologic and morphological characteristics presented in our study can aid in the identification, clinical understanding, and surgical excision of a symptomatic CCJ. Level of Evidence: Level IV.

scholarly journals A Novel Retensioning Technique for Arthroscopic Repair of PASTA Lesions: A Clinical and Radiologic Outcome Study of 24 Shoulders

2021 ◽  
Vol 9 (3) ◽  
pp. 232596712098688
Author(s):  
Su Cheol Kim ◽  
Jong Ho Jung ◽  
Sang Min Lee ◽  
Jae Chul Yoo
Keyword(s):  
Constant Score ◽  
Case Series ◽  
Tendon Healing ◽  
Shoulder Abduction ◽  
Level Of Evidence ◽  
Simple Shoulder Test ◽  
Shoulder Range Of Motion ◽  
Functional Scores ◽  
The Mean

Background: There is no consensus on the ideal treatment for partial articular supraspinatus tendon avulsion (PASTA) lesions without tendon damage. Purpose: To introduce a novel “retensioning technique” for arthroscopic PASTA repair and to assess the clinical and radiologic outcomes of this technique. Study Design: Case series; Level of evidence, 4. Methods: A retrospective analysis was performed on 24 patients whose PASTA lesion was treated using the retensioning technique between January 2011 and December 2015. The mean ± SD patient age was 57.6 ± 7.0 years (range, 43-71 years), and the mean follow-up period was 57.6 ± 23.4 months (range, 24.0-93.7 months). Sutures were placed at the edge of the PASTA lesion, tensioned, and fixed to lateral-row anchors. After surgery, shoulder range of motion (ROM) and functional scores (visual analog scale [VAS] for pain, VAS for function, American Shoulder and Elbow Surgeons [ASES] score, Constant score, Simple Shoulder Test, and Korean Shoulder Score) were evaluated at regular outpatient visits; at 6 months postoperatively, repair integrity was evaluated using magnetic resonance imaging (MRI). Results: At 12 months postoperatively, all ROM variables were improved compared with preoperative values, and shoulder abduction was improved significantly (136.00° vs 107.08°; P = .009). At final follow-up (>24 months), the VAS pain, VAS function, and ASES scores improved, from 6.39, 4.26, and 40.09 to 1.00, 8.26, and 85.96, respectively (all P < .001). At 6 months postoperatively, 21 of the 24 patients (87.5%) underwent follow-up MRI; the postoperative repair integrity was Sugaya type 1 or 2 for all of these patients, and 13 patients showed complete improvement of the lesion compared with preoperatively. Conclusion: The retensioning technique showed improved ROM and pain and functional scores as well as good tendon healing on MRI scans at 6-month follow-up in the majority of patients. Thus, the retensioning technique appears to be reliable procedure for the PASTA lesion.

Abstract P284: Role of a Genetic Risk Score with Dietary Intake and Physical Activity in Relation to Metabolic Syndrome

Circulation ◽  
2016 ◽  
Vol 133 (suppl_1) ◽  
Author(s):  
Dale S Hardy ◽  
Tesfaye Mersha ◽  
Hongyan Xu ◽  
Susan Racette
Keyword(s):  
Physical Activity ◽  
Logistic Regression ◽  
African Americans ◽  
Food Intake ◽  
Genetic Risk ◽  
Genetic Risk Score ◽  
Statistical Significance ◽  
Multivariate Logistic Regression ◽  
Animal Fat ◽  
Aric Study

Background: Studies have found associations between genetic polymorphisms, food intake, physical activity, body mass index, and metabolic syndrome (METs). Objective: We hypothesized that a genetic risk score (GRS) with food intake and physical activity are influenced by mediational and interaction effects to increase METs among White and African American adults. Methods: We used the Atherosclerosis Risk In Communities (ARIC) study data at the third visit from 1996-1998. Data included 8,416 Whites and 2,061 African Americans aged 41-71y with 1,484 and 517 cases of METs, respectively. METs was defined according to the International Diabetes Federation criteria. Dietary data were obtained from the ARIC study food frequency questionnaire. The GRS was composed of eight single nucleotide polymorphisms involved in cardiovascular and lipid metabolism, known to have defects in protein binding and function. Mediational path analysis using linear-and-logistic regression was used to test simultaneous associations, and interaction using multivariate logistic regression tested relationships between the GRS, food intake, physical activity and METs. In mediational path analysis, Root Mean Square Error of Approximation, p>0.05, Comparative Factor Index, p>0.90, Tucker-Lewis Index, p>0.90, and chi-square test, p>0.05 were used to assess statistical significance. For interaction using logistic regression analysis, odds ratios (OR) and 95% confidence intervals with p<0.05 were used to judge statistical significance. Results: In multivariate logistic regression, the GRS was associated with a 22% increased risk for METs among Whites (OR=1.22; 1.03-1.44), while this association was not significant in African Americans. After adjustment for Bonferonni correction for mass significance (p<0.001), we found among Whites that energy-adjusted total fat, animal fat, caloric intake, sugar-sweetened drinks, red meat, fried foods, and processed meats were associated with higher risk for METs, while energy-adjusted total carbohydrates, crude fiber, dietary fiber, and cereal fiber had a protective association with METs. These results were similar in African Americans but did not meet Bonferonni significance. In mediational analysis, we observed insignificant mediational effects, but significant direct effects for the GRS to METs for physical activity (OR=1.164; p=0.047) and fish intake (OR=1.161; p=0.050) among Whites and for carbohydrate intake (OR=1.164; p=0.058) and drinks consumed (OR=4.445; p<0.0000) among overweight/obese Whites. In interaction models, energy-adjusted carbohydrate, protein, animal fat, fructose, and sugary drinks interacted with the GRS to affect METs among Whites, but not African Americans. Conclusion: A GRS operates through interaction with dietary factors and physical activity rather than by their mediational effects on METs among White adults.

scholarly journals Racial Differences in Immunological Landscape Modifiers Contributing to Disparity in Prostate Cancer

Cancers ◽  
2019 ◽  
Vol 11 (12) ◽  
pp. 1857 ◽  
Author(s):  
Jeronay King Thomas ◽  
Hina Mir ◽  
Neeraj Kapur ◽  
Shailesh Singh
Keyword(s):  
Prostate Cancer ◽  
African Americans ◽  
Racial Differences ◽  
Treatment Interventions ◽  
Rapid Disease Progression ◽  
Caucasian Americans ◽  
Expression Of Genes ◽  
Therapeutic Outcomes ◽  
Immunosuppressive Tumor Microenvironment ◽  
Aggressive Tumors

Prostate cancer affects African Americans disproportionately by exhibiting greater incidence, rapid disease progression, and higher mortality when compared to their Caucasian counterparts. Additionally, standard treatment interventions do not achieve similar outcome in African Americans compared to Caucasian Americans, indicating differences in host factors contributing to racial disparity. African Americans have allelic variants and hyper-expression of genes that often lead to an immunosuppressive tumor microenvironment, possibly contributing to more aggressive tumors and poorer disease and therapeutic outcomes than Caucasians. In this review, we have discussed race-specific differences in external factors impacting internal milieu, which modify immunological topography as well as contribute to disparity in prostate cancer.

scholarly journals Frozen section analysis for organ-conserving surgery in penile cancer: Assessing oncological outcomes and trends of local recurrence

2020 ◽  
Vol 13 (6) ◽  
pp. 419-424
Author(s):  
T Ellul ◽  
P Grice ◽  
A Mainwaring ◽  
N Bullock ◽  
A Shanahan ◽  
...  
Keyword(s):  
Local Recurrence ◽  
Penile Cancer ◽  
Frozen Section ◽  
Surgical Margin ◽  
Positive Margin ◽  
Surgical Excision ◽  
Recurrence Rates ◽  
Level Of Evidence ◽  
Positive Margins ◽  
Positive Margin Rate

Introduction and objectives: The local recurrence rate of penile cancer following surgical excision is reported in many series to be between 6 and 29%. Intra-operative frozen section (FS) is a useful tool to ensure safe microscopic margins in organ-sparing procedures in penile cancer. In this series, we assessed the rates of positive margins and patterns of local recurrence in a multicentre cohort of patients undergoing penile-preserving surgery assisted by intra-operative FS analysis. Materials and methods: We reviewed all those patients for whom intra-operative FS was employed during penile-preserving surgery in three tertiary referral centres between 2003 and 2016. We assessed whether the use of FS altered the surgical technique and what affect it had on positive margins and recurrence rates. Results: A total of 169 patients were identified. Of these, intra-operative FS examination of the surgical margin was positive in 21 (12%) cases. Final histological examination confirmed cancer-free margins in all but one patient (99.4%). Overall, 9 patients developed local recurrence (5.3%). Conclusions: In this series, intra-operative FS contributed to a very low rate (5.3%) of local recurrence. We noted an extremely low positive margin rate (0.6%) which highlights the benefit of incorporating FS analysis into organ-preserving surgery for penile cancer. Level of evidence: Not applicable for this multicentre audit.

Comparison of the Incidences of Obstructive Sleep Apnea-Hypopnea Syndrome in African-Americans versus Caucasian-Americans

2006 ◽  
Vol 134 (4) ◽  
pp. 545-550 ◽  
Author(s):  
Michael Friedman ◽  
Darius Bliznikas ◽  
Michaela Klein ◽  
Praveen Duggal ◽  
M. Somenek ◽  
...  
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
African Americans ◽  
Caucasian Americans ◽  
Obstructive Sleep ◽  
Hypopnea Syndrome

scholarly journals Predictors of Retention Among African Americans in a Randomized Controlled Trial to Test the Healthy Eating and Active Living in the Spirit (HEALS) Intervention

2017 ◽  
Vol 27 (3) ◽  
pp. 265 ◽  
Author(s):  
Oluwole A. Babatunde ◽  
Swann Arp Adams ◽  
Micheal D. Wirth ◽  
Jan M. Eberth ◽  
Jameson Sofge ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Logistic Regression ◽  
African Americans ◽  
Behavioral Interventions ◽  
Minority Groups ◽  
Controlled Trial ◽  
Intervention Group ◽  
Normal Weight ◽  
Morbidly Obese ◽  
Randomized Controlled

<p class="Pa7"><strong>Introduction: </strong>Retention of racial/ethnic minority groups into research trials is neces­sary to fully understand and address health disparities. This study was conducted to identify participants’ characteristics associ­ated with retention of African Americans (AAs) in a randomized controlled trial (RCT) of a behavioral intervention.</p><p class="Pa7"><strong>Methods: </strong>Using data from an RCT con­ducted from 2009 to 2012 among AAs, participant-level factors were examined for associations with retention between three measurement points (ie, baseline, 3-month, and 12-month). Chi-square tests and logistic regression analyses were conducted to compare retained participants to those who were not retained in order to identify important predictors of retention.</p><p class="Pa7"><strong>Results: </strong>About 57% of participants (n=238) were retained at 12 months. Baseline char­acteristics that showed a statistically signifi­cant association with retention status were age, marital status, body mass index (BMI), intervention group, enrollment of a partner in the study, and perceived stress score (PSS). Multivariable logistic regression that adjusted for age, BMI, and PSS showed the odds of being retained among participants who enrolled with a partner was 2.95 (95% CI: 1.87-4.65) compared with participants who had no study partner enrolled. The odds of being retained among participants who were obese and morbidly obese were .32 and .27 (95% CI: .14-.74 and .11-.69), respectively, compared with participants who had normal weight.</p><p><strong>Conclusion: </strong>Having a partner enrolled in behavioral interventions may improve retention of study participants. Researchers also need to be cognizant of participants’ obesity status and potentially target reten­tion efforts toward these individuals. <em></em></p><p><em>Ethn Dis. </em>2017;27(3):265-272; doi:10.18865/ed.27.3.265.</p><strong></strong>

scholarly journals Does Flipping the Tubercle for Improved Cartilage Repair Exposure Increase the Risk for Arthrofibrosis?

Cartilage ◽  
2020 ◽  
pp. 194760352096820
Author(s):  
Gergo Merkely ◽  
Jakob Ackermann ◽  
Emily Sheehy ◽  
Andreas H. Gomoll
Keyword(s):  
Logistic Regression ◽  
Cartilage Repair ◽  
Regression Models ◽  
Case Control Study ◽  
Level Of Evidence ◽  
Logistic Regression Models ◽  
Increased Risk ◽  
Repair Procedure ◽  
Control Study

Objective We sought to determine whether rates of postoperative arthrofibrosis following tibial tuberosity osteotomy (TTO) with complete mobilization of the fragment (TTO-HD) are comparable to TTOs where the hinge remained intact (TTO-HI). Design Patients who underwent TTO with concomitant cartilage repair procedure between January 2007 and May 2017, with at least 2 years of follow-up were included in this study. Postoperative reinterventions following TTO-HD and TTO-HI were assessed and multivariant logistic regression models were used to identify whether postoperative reinterventions can be attributed to either technique when controlled for defect size or defect number. Results A total of 127 patients (TTO-HD, n = 80; TTO-HI, n = 47) were included in this study. Significantly more patients in the TTO-HD group (31.2%) developed postoperative arthrofibrosis compared with TTO-HI (6.4%; P < 0.05). Multivariant logistic regression revealed that TTO-HD is an independent risk factor for predicting postoperative arthrofibrosis (OR 6.5, CI = 1.7-24.2, P < 0.05). Conclusion Patients who underwent TTO with distal hinge detachment and a proximally flipped tubercle for better exposure during concomitant cartilage repair were at a significantly higher risk of postoperative arthrofibrosis than patients with similar size and number of defects treated without mobilization of the tubercle. While certain procedures can benefit from larger exposure, surgeons should be aware of the increased risk of postoperative arthrofibrosis. Level of Evidence Level III, case-control study.

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