scholarly journals Epidemiology of Paediatric Shoulder Dislocation: A Nationwide Study in Italy from 2001 to 2014

2020 ◽  
Vol 17 (8) ◽  
pp. 2834 ◽  
Author(s):  
Umile Giuseppe Longo ◽  
Giuseppe Salvatore ◽  
Joel Locher ◽  
Laura Ruzzini ◽  
Vincenzo Candela ◽  
...  
Keyword(s):  
Shoulder Dislocation ◽  
Young Patients ◽  
Skeletally Immature ◽  
The South ◽  
Paediatric Patients ◽  
Open Stabilization ◽  
Hospital Discharge Records ◽  
Low Incidence ◽  
Incidence Of Hospitalization ◽  
Geographical Diversification

Limited knowledge is accessible concerning the tendencies of hospitalization for skeletally immature patients with episodes of shoulder dislocation. Our research aim was to evaluate annual hospitalizations for shoulder dislocation in paediatric patients in Italy from 2001 to 2014, on the basis of the official data source as hospitalization reports. The second purpose was to investigate geographical diversification in hospitalization for shoulder dislocation in regions of Italy. The last aim was to make statistical predictions of the number of shoulder dislocation hospitalization volumes and rates in skeletally immature patients based on data from 2001 to 2014. An examination of the National Hospital Discharge records (SDO) kept at the Italian Ministry of Health regarding the 14 years of our study (2001 through 2014) was conducted. These data are anonymous and include patient’s age, gender, domicile, region and time of hospitalization, and the kind of reimbursement (public or private). In the 14-year study time, 344 hospitalizations for shoulder dislocation of patients aged 0–14 years took place in Italy. The male/female hospitalization ratio varied from a maximum of 3.0 (2001) to a minimum of 1.1 (2013), with a mean average ratio in the 2001–2014 timespan of 2.0. Almost half of the hospitalizations (49.1%) were performed in the South. The mean incidence of hospitalizations in Italy for shoulder dislocation in patients with less than 14 years was 0.3 for every 100,000 inhabitants in the same class of age. The most common treatment was a closed reduction (60.8%), followed by open stabilization (16.6%) and arthroscopic procedures (13.7%). The present registry study shows a low incidence of hospitalization for shoulder dislocation in young patients. The most common treatment for a shoulder dislocation in paediatric patients is a closed shoulder reduction. Regions from the south and the centre of Italy are marked by an inferior number of operations and a higher number of hospitalization for closed shoulder reduction.

scholarly journals Outcome of Corneal Collagen Crosslinking for Progressive Keratoconus in Paediatric Patients

2014 ◽  
Vol 2014 ◽  
pp. 1-5 ◽  
Author(s):  
Deepa Viswanathan ◽  
Nikhil L. Kumar ◽  
John J. Males
Keyword(s):  
Young Patients ◽  
Ultraviolet A ◽  
Effective Treatment Option ◽  
Collagen Crosslinking ◽  
Paediatric Patients ◽  
Corneal Grafting ◽  
Minimum Angle ◽  
Corneal Collagen Crosslinking ◽  
The Mean ◽  
Corneal Collagen

Purpose. To evaluate the efficacy of corneal collagen crosslinking for progressive keratoconus in paediatric patients.Methods. This prospective study included 25 eyes of 18 patients (aged 18 years or younger) who underwent collagen crosslinking performed using riboflavin and ultraviolet-A irradiation (370 nm, 3 mW/cm2, 30 min).Results. The mean patient age was 14.3 ± 2.4 years (range 8–17) and mean followup duration was 20.1 ± 14.25 months (range 6–48). Crosslinked eyes demonstrated a significant reduction of keratometry values. The mean baseline simulated keratometry values were 46.34 dioptres (D) in the flattest meridian and 50.06 D in the steepest meridian. At 20 months after crosslinking, the values were 45.67 D (P=0.03) and 49.34 D (P=0.005), respectively. The best spectacle corrected visual acuity (BSCVA) and topometric astigmatism improved after crosslinking. Mean logarithm of the minimum angle of resolution (logMAR) BSCVA decreased from 0.24 to 0.21 (P=0.89) and topometric astigmatism reduced from mean 3.50 D to 3.25 D (P=0.51).Conclusions. Collagen crosslinking using riboflavin and ultraviolet-A is an effective treatment option for progressive keratoconus in paediatric patients. Crosslinking stabilises the condition and, thus, reduces the need for corneal grafting in these young patients.

scholarly journals Bilateral Diabetic Knee Neuroarthropathy in a Forty-Year-Old Patient

2016 ◽  
Vol 2016 ◽  
pp. 1-4 ◽  
Author(s):  
Patrick Goetti ◽  
Nicolas Gallusser ◽  
Olivier Borens
Keyword(s):  
Joint Destruction ◽  
Young Patients ◽  
Joint Disease ◽  
Diabetic Patients ◽  
Type I ◽  
Bilateral Involvement ◽  
Satisfactory Outcome ◽  
History Of ◽  
Diabetes Type I ◽  
Low Incidence

Diabetic osteoarthropathy is a rare cause of neuropathic joint disease of the knee; bilateral involvement is even more exceptional. Diagnosis is often made late due to its unspecific symptoms and appropriate surgical management still needs to be defined, due to lack of evidence because of the disease’s low incidence. We report the case of a forty-year-old woman with history of diabetes type I who developed bilateral destructive Charcot knee arthropathy. Bilateral total knee arthroplasty was performed in order to achieve maximal functional outcome. Follow-up was marked by bilateral tibial periprosthetic fractures treated by osteosynthesis with a satisfactory outcome. The diagnosis of Charcot arthropathy should always be in mind when dealing with atraumatic joint destruction in diabetic patients. Arthroplasty should be considered as an alternative to arthrodesis in bilateral involvement in young patients.

scholarly journals Predictive Factors of Development of Graves’ Ophthalmopathy for Patients with Juvenile Graves’ Disease

2016 ◽  
Vol 2016 ◽  
pp. 1-9 ◽  
Author(s):  
Dalia Jarusaitiene ◽  
Rasa Verkauskiene ◽  
Vytautas Jasinskas ◽  
Jurate Jankauskiene
Keyword(s):  
Predictive Factors ◽  
Young Patients ◽  
Cross Sectional Study ◽  
Graves Disease ◽  
Cross Sectional ◽  
Ocular Manifestations ◽  
Graves Ophthalmopathy ◽  
Graves Orbitopathy ◽  
Low Incidence ◽  
Major Factors

Background. Due to low incidence of Graves’ ophthalmopathy (GO) among children, the manifestation is poorly analyzed, posing a risk to late identification of insidious disease.Purposes. To identify predictive factors that may influence the development of GO in pediatric and young patients with Graves’ disease (GD).Methods. A cross-sectional study of patients newly diagnosed with pediatric or juvenile GD during 2002–2012 was conducted at the Hospital of Lithuanian University of Health Sciences. Ocular evaluation was based on European Group on Graves’ Orbitopathy survey. The ocular manifestations were analyzed in relation to demographic, environmental, and clinical factors.Results. In total, 130 patients with juvenile GD were included; 29.2% had GO. Median age at GD onset was 17 yrs (IQR 4–29). Main symptoms of GO were eyelids retraction (73.7%), proptosis (65.8%), injection of conjunctiva (42.1%), and eyeball motility disturbance (21.1%). Major significant and independent risk factors for GO development were high initial concentration of FT4 (OR = 5.963), TTHAb (OR = 6.358), stress (OR = 6.030), and smoking (OR = 7.098).Conclusion. The major factors that could influence GO development were smoking, stress, and increased levels of initial TRAb, FT4. Slight proptosis, retraction of eyelids, and conjunctive injection were found as predominant ophthalmological symptoms in juvenile GO.

scholarly journals TRENDS IN PEDIATRIC ANTERIOR CRUCIATE LIGAMENT RECONSTRUCTION: A REVIEW OF SURGEON FELLOWSHIP, GEOGRAPHY, AND MENISCUS SURGERY IN THE ABOS PART 2 DATABASE

2019 ◽  
Vol 7 (3_suppl) ◽  
pp. 2325967119S0007
Author(s):  
Henry B. Ellis ◽  
Curtis VandenBerg ◽  
Jennifer Beck ◽  
Andrew Pennock ◽  
Aristides I. Cruz ◽  
...  
Keyword(s):  
Geographic Variation ◽  
Acl Reconstruction ◽  
Sports Medicine ◽  
Cruciate Ligament ◽  
Young Patients ◽  
Meniscal Repair ◽  
Fellowship Training ◽  
Geographic Region ◽  
The South ◽  
Time Period

INTRODUCTION: An increased rate of pediatric and adolescent patients undergoing ACL reconstruction has clearly been established, and now considered one of the most common arthroscopic procedures performed in youth patients. Little knowledge exists on whether these trends truly represent an increase in ACL injury, identification, or surgical management. Trends, including surgeon training, meniscus treatment, or geographic differences, have not been reported. The purpose of this study was to review data from ACL reconstructions performed in patients under the age of 17 years, that were submitted to the American Board of Orthopaedic Surgeons (ABOS) Part 2 examination, with a goal of evaluating national treatment trends over a 16-year period. METHODS: A query to the ABOS SCRIBE database was submitted for all ACL reconstructions performed in patients less than 17 years old between 2002 and 2016. The query was designed to search for CPT procedure codes submitted by each applicant. Query data included geographic region, fellowship training of the applicant, age and sex of the patients, and associated procedures. Each case had an associated applicant number, and thus, the total number of ACL reconstructions performed by each surgeon during board collection was provided. Trends were reviewed for the aggregate data and a Mann-Whitney test was used for comparison of data between 2002 – 2009 (Early-ACL) and 2010-2016 (Recent-ACL) groups. RESULTS: Since 2002, there has been a 2.6% increase in pediatric ACL reconstructions performed by candidates applying for Part 2 of the ABOS examination. Additionally, a 193% increase in dual pediatric and sports medicine fellowship trained candidates performing pediatric ACL reconstruction since 2010 was seen. A majority of pediatric ACL procedures were performed by sports medicine trained surgeons (75.9%). During this time period, a total of 362 (or 8.3%) of pediatric ACL procedures were performed by surgeons with neither sports medicine nor pediatric orthopaedic fellowship training. Following 2009, a 44% increase in pediatric ACL reconstructions performed was noted (Figure 1A). Additionally, an increase in reconstructions performed in female patients compared to males was noted (Figure 1B). A majority of pediatric ACL reconstructions did not require additional meniscal treatment, however, meniscus repair was more likely to be performed after 2009 (p=0.0012). The number of meniscal repair procedures reported in the setting of ACL reconstruction generally increased over the study period. In 2002, 24% of ACL reconstructions required a meniscal repair compared to 41% in 2016 (Figure 1C). A majority of these repairs were performed by surgeons with sports medicine fellowship training. Geographic trends reported are based on patients <16 per available census records (Figure 1D). Geographic variation exists with of the highest rates of pediatric ACL reconstructions occurring in the South (4.62 per million) and Midwest (4.07 per million) in comparison to the Southeast (1.85 per million). When adjusting for population size per year, each region saw a significant increase in reported ACL surgeries from the Early-ACL to the Recent-ACL timeframe (p=0.005). The largest increases in surgeries reported between Early-ACL and Recent-ACL were seen in the Southeast (68% increase), Midwest (50% increase) and Southwest (47% increase). Of all the providers who performed surgery, 74% submitted only 1-2 cases from 2002-2016, with 26% of providers performing more than 55% of all of the pediatric ACL reconstruction cases. More than 75% of all cases were performed by sports medicine fellowship trained surgeons However, a large change was seen in dual sports and pediatric trained surgeon case volumes over this time period, with these surgeons performing 7.5 times more surgeries from 2010 to 2016 (Recent-ACL) when compared to 2002-2009 (Early-ACL). CONCLUSION: Since 2009, pediatric ACL reconstructions are more likely to be female and are more likely to undergo a meniscal repair. Geographic variation is noticeable, with more surgeries reported to be performed in the South. Dual pediatric and sports medicine fellowship trained candidates performing ACL reconstruction have significantly increased over time, although those surgeons who are only sports medicine fellowship trained continue to perform the bulk of ACL reconstructions in young patients.

Trichinellosis in the south and the Far East of the Russian Federation

2020 ◽  
pp. 41-46
Keyword(s):  
Russian Federation ◽  
Far East ◽  
Federal District ◽  
Control Measures ◽  
The South ◽  
The Russian Federation ◽  
Low Incidence ◽  
The One ◽  
Far Eastern ◽  
Reservoir Hosts

The evaluated territories have favorable environment for functional foci of trichinellosis. Despite wide spread, natural focality and a large variety of animals that are reservoir hosts of Trichinella, trichinellosis is a preventable invasion. It was possible to maintain a low incidence rate of this disease in the Southern Federal district and North Caucasian Federal District for many years due to veterinary and epidemiological control measures. However, structure of factors that facilitate infestation with trichinellosis in the Far Eastern Federal district is substantially different from the one prevailing in the south territories of the Russian Federation. The major sources of invasion is meat of wild animals and dogs that do not undergo veterinary-sanitary examination. As a result, the Far Eastern Federal district has one of the highest rates of trichinellosis cases registered in the Russian Federation.

Return to play in children with shunted hydrocephalus

2021 ◽  
pp. 1-9
Author(s):  
Agnieszka Stanuszek ◽  
Adam Bębenek ◽  
Olga Milczarek ◽  
Stanisław Kwiatkowski
Keyword(s):  
Medical Literature ◽  
Univariate Analysis ◽  
Young Patients ◽  
Return To Play ◽  
Neurological Deficits ◽  
Before And After ◽  
Sport Activities ◽  
Neurosurgical Treatment ◽  
Low Incidence

OBJECTIVE The objective of this study was to assess the relevance of shunted hydrocephalus in regard to participation by young patients in physical education (PE) classes. Students diagnosed with this condition are very often restricted in PE classes owing to the lack of official and well-defined guidelines. However, the medical literature suggests that there is no relationship between the disease and risk of sport-related injuries. In this study, the authors intended to evaluate not only the accuracy of this statement, but also to explore the factors that delay or foreclose return to exercise. METHODS The analysis was conducted on patients aged < 18 years with a diagnosis of shunt-treated hydrocephalus who received follow-up for a minimum of 1 year. Collected medical data were examined for factors limiting participation in PE at school. Indicators of both sport-related injuries and conditions acceptable for return to exercise were gathered during follow-up visits. RESULTS In this study, 72.72% of patients attended sport activities in schools. The group based on return to PE class differed significantly in the occurrence of neurological deficits, as well as presence of comorbidities. In univariate analysis, the authors identified these parameters as risk factors limiting participation in PE. On the contrary, etiology of hydrocephalus, type of shunting device, number of shunt malfunctions, and presence of epilepsy did not significantly influence sport engagement. CONCLUSIONS This study shows that many patients with shunt-treated hydrocephalus can safely participate in PE. Presence of neurological deficits before and after neurosurgical treatment, as well as presence of comorbidities, are factors that negatively impact the possibility of a patient returning to physical activity. Sport-related injuries do occur, but at a low incidence.

scholarly journals Osteochondritis Dissecans in the Knee of Skeletally Immature Patients: Rates of Persistent Pain, Osteoarthritis, and Arthroplasty at Mean 14-Years’ Follow-Up

Cartilage ◽  
2018 ◽  
Vol 11 (3) ◽  
pp. 291-299 ◽  
Author(s):  
Mario Hevesi ◽  
Thomas L. Sanders ◽  
Ayoosh Pareek ◽  
Todd A. Milbrandt ◽  
Bruce A. Levy ◽  
...  
Keyword(s):  
Risk Factors ◽  
Knee Pain ◽  
Osteochondritis Dissecans ◽  
Female Gender ◽  
Operative Management ◽  
Magnetic Resonance Images ◽  
Skeletally Immature ◽  
Risk Patients ◽  
Low Incidence

Objective Osteochondritis dissecans (OCD) is a knee disorder of predominately pediatric populations. Because of low incidence, it has traditionally been difficult to study OCD. The purpose of this study was to report long-term outcomes of skeletally immature OCD lesions and determine risk factors for persistent knee pain at final follow-up. Design A geographic database of more than 500,000 patients was reviewed to identify patients with knee OCD. Clinical course including operative management, persistent knee pain, and total knee arthroplasty (TKA) were analyzed through review of radiographs, magnetic resonance images, and physician notes. Results A total of 95 skeletally immature patients (70 male, 25 female, mean age 12.5 ± 2.0 years) were followed for a mean of 14 years (range, 2-40 years). Fifty-three patients were treated operatively and 42 were treated nonoperatively. At final follow-up, 13 patients noted persistent knee pain, 8 treated operatively versus 5 treated nonoperatively. Risk factors for knee pain were female gender, patellar lesions, and unstable lesions. Four patients (8%) treated operatively and 2 patients (5%) treated nonoperatively developed symptomatic osteoarthritis at a mean of 28.6 years following diagnosis. Three patients underwent TKA at a mean age of 52 years, significantly younger than that observed for primary TKA at our institution ( P = 0.004). Conclusions Skeletally immature OCD patients have promising histories, with an estimated 14% risk of persistent knee pain, 6% symptomatic osteoarthritis, and 3% conversion to TKA at 14 years’ mean follow-up. Females, patellar lesions, and unstable lesions demonstrated increased persistent knee pain risk. Patients with OCD undergo TKA at a significantly younger age than the general population.

scholarly journals Conservative management of first-time traumatic anterior shoulder dislocation

2021 ◽  
Author(s):  
Benedikt Schliemann ◽  
Marvin Minkus ◽  
Dominik Seybold ◽  
Markus Scheibel
Keyword(s):  
Conservative Management ◽  
Shoulder Dislocation ◽  
External Rotation ◽  
Young Patients ◽  
Clinical Results ◽  
Current Evidence ◽  
Anterior Shoulder Dislocation ◽  
Recurrence Rates ◽  
Traumatic Anterior Shoulder Dislocation ◽  
First Time

AbstractTraumatic anterior shoulder dislocation is a common injury in young and active patients and the proper treatment is still a matter of debate. The recurrence rate after conservative management remains high and, therefore, primary surgical intervention is sometimes recommended in very young patients whose risk of recurrences is highest. Immobilization in external rotation, first described by Itoi, is a promising conservative option as it provides adequate labral reduction and low recurrence rates. Recent meta-analyzes could not unequivocally demonstrate its superiority over internal rotation immobilization. However, biomechanical and early clinical results show a better effect on reduction of the labrum and lower recurrence rates for immobilization in a combination of abduction/external rotation than for external rotation alone. The present article aims to provide an overview of the conservative management of first-time traumatic shoulder dislocation in order to provide the treating physician or surgeon with the best current evidence as a basis for developing the appropriate treatment strategy for the patient.

scholarly journals Functional outcome of arthroscopic Bankart repair in post-traumatic recurrent shoulder dislocation in a private tertiary care teaching hospital in eastern India

2020 ◽  
Vol 6 (6) ◽  
pp. 1233
Author(s):  
Ayon Das ◽  
Subhrojyoti Bhowmick ◽  
Nikhilesh Das ◽  
Swarnendu Samanta ◽  
Somanth De ◽  
...  
Keyword(s):  
Range Of Motion ◽  
Shoulder Dislocation ◽  
Full Range ◽  
Tertiary Care ◽  
Young Patients ◽  
Bankart Repair ◽  
Care Hospital ◽  
Shoulder Range Of Motion ◽  
Arthroscopic Bankart Repair ◽  
Post Traumatic

<p class="abstract"><strong>Background: </strong>Recurrent anterior shoulder dislocations are quite common in young patients with Bankart lesions. The open Bankart repair was the gold standard for years, however arthroscopic Bankart repair has gained popularity. The aim of the study was to evaluate the functional results of arthroscopic Bankart repair in patients with post-traumatic recurrent anterior glenohumeral instability.</p><p class="abstract"><strong>Methods: </strong>Patients who underwent arthroscopic Bankart repair for post-traumatic recurrent anterior shoulder dislocation were included in the study. This was a prospective study conducted at a tertiary care Hospital in Kolkata, India between August 2017 to May 2019. All patients were followed up at an interval of 2 weeks, 6 weeks, 12 weeks, 6 months, 9 months and 1 year. Rowe score was used to assess the functional outcomes of the patients.</p><p class="abstract"><strong>Results:</strong> 34 (91.9%) patients reported good to excellent results, whereas only 2 (5.4%) patients had fair outcome and 1 (2.7%) patient demonstrated poor surgical result. The total rowe score improved from 46.62 pre-operatively to 94.20 post-operatively after 1 year (p&lt;0.01). By the end of 1-year follow-up, 35 (94.6%) patients had full range of motion in all the planes. Majority of (89.2%) patients did not have any complications. Only 1 patient out of 37 had a recurrence (2.7%).</p><p class="abstract"><strong>Conclusion: </strong>Arthroscopic Bankart repair is an effective, cosmetic and safe surgical procedure with good clinical outcomes and excellent post-operative shoulder range of motion. This surgical intervention also has low recurrence rate and minimum surgical complications.</p>

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