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Ciais G, Massin V, Tibbo M, Dardenne T, Abdellaoui M, Ricón J, Antoni M, Laumonerie P. Stress shielding following radial head arthroplasty: the impact of preoperative bone quality. J Shoulder Elbow Surg 2024:S1058-2746(24)00302-1. [PMID: 38697508 DOI: 10.1016/j.jse.2024.03.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Revised: 02/21/2024] [Accepted: 03/03/2024] [Indexed: 05/05/2024]
Abstract
INTRODUCTION We sought to assess if the medullary diameter to cortical width ratio (MD:CW), canal flair index (CFI), and canal fill (CF) of the proximal radius were associated with the presence of Stress shielding (SS) after a MoPyC radial head arthroplasty (RHA). MATERIAL & METHOD We conducted a retrospective, international, multicenter (4 centers) study. A total of 100 radial head arthroplasties in 64 women and 36 men with a mean age of 58.40 years ±14.90 (range, 25.00; 91.00) were included. Radiographic measurements, including MD:CW, CFI, CF, and postoperative SS were captured at a mean follow-up of 3.9 years ±2.8 (range, 0.5-11). RESULTS Stress shielding was identified in 60 patients. Mean preoperative MD:CW, CFI, and CF were 0.55 ±0.09, 1.05 ±0.18 and 0.79±0.11, respectively. The presence of SS was significantly associated with MD:CW (aOR=13.66; p=0.001), and expansion of the stem (aOR=3.78; p=0.001). The amount of the SS was significantly correlated with expansion of the stem (aβ 4.58; p<0.001). CONCLUSIONS Our study found that MD:CW was an independent risk factor of SS after Mopyc RHA. Patients with longer and larger diameter (auto-expansion) Mopyc stems were also at significantly increased risk of SS. Further studies involving multiple implants designs are needed to confirm the preliminary observations presented in the current study.
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Affiliation(s)
- Grégoire Ciais
- Department of Orthopedic Surgery, Clinique Jouvenet, Paris, France
| | - Valentin Massin
- Department of Orthopedic Surgery, La Timone hospital, Marseille, France
| | - Meagan Tibbo
- Department of Orthopedic Surgery, Mayo Clinic, Phoenix, AZ, USA
| | - Theopol Dardenne
- Department of Orthopedic Surgery, Pellegrin hospital, Bordeaux, France
| | | | - Javier Ricón
- Department of Orthopedic Surgery, Vega Baja, Orihuela, Spain
| | - Maxime Antoni
- Department of Orthopedic Surgery, Clinique de l'orangerie, Strasbourg, France
| | - Pierre Laumonerie
- Department of Orthopedic Surgery, Pellegrin hospital, Bordeaux, France.
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Baltassat A, Riffault L, Villatte G, Meyer N, Antoni M, Clavert P. History of mood and anxiety disorders affects return to work and return to sports after rotator cuff repair. Orthop Traumatol Surg Res 2024:103854. [PMID: 38432470 DOI: 10.1016/j.otsr.2024.103854] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Revised: 09/19/2023] [Accepted: 10/17/2023] [Indexed: 03/05/2024]
Abstract
INTRODUCTION After rotator cuff repair (RCR), return to work and return to sports is affected by various psychosocial factors. The role of one of these factors - mood and anxiety disorders (MAD) - is still not clear. The primary objective of this study was to determine the influence of prior MAD on the return to work and return to sports after RCR. Our hypothesis was that patients with a history of MAD would take longer to return to work and to sports after RCR, and the rate of return would be lower, than for patients without MAD. MATERIALS AND METHODS This was a retrospective single-center study of patients who underwent arthroscopic RCR (distal supraspinatus tear). Patients who were employed and those who participated in sports before the surgery were included in the "working" and "sports" groups, respectively. The primary outcomes were the time to return to work and return to sports after surgery. The secondary outcomes were the ratio of patients returning to work and to sports at 3, 6 and 12 months; rate of return to same level of sports; need to change or stop working or sports. The effects of prior MAD on these various outcomes were determined using Bayesian multivariate analysis. RESULTS The "working" group consisted of 158 patients (of which 16.5% had MAD) and the "sports" group consisted of 118 patients (of which 17.8% had MAD). In those with a history of MAD, return to work was 21±11 weeks later and the return to sports was 17±8 weeks later than in those without MAD. There was a 98% probability that return to work or return to sports was delayed by at least 4 weeks in patients with history of MAD. The likelihood that patients with prior MAD who undergo RCR will completely abandon their sport was 2.8 times higher (OR=2.8 [1; 7.8]). CONCLUSION We found a negative influence of prior MAD on the return to work and return to sports after RCR. LEVEL OF EVIDENCE III; retrospective case-control study.
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Affiliation(s)
- Antoine Baltassat
- Service de chirurgie du membre supérieur, hôpital de Hautepierre 2, CHU de Strasbourg, avenue Molière, 67000 Strasbourg, France
| | - Louis Riffault
- Service de chirurgie du membre supérieur, hôpital de Hautepierre 2, CHU de Strasbourg, avenue Molière, 67000 Strasbourg, France
| | - Guillaume Villatte
- Service de chirurgie orthopédique et traumatologique, CHU de Clermont-Ferrand, 58, rue Montalembert, 63000 Clermont-Ferrand, France
| | - Nicolas Meyer
- Service de chirurgie du membre supérieur, hôpital de Hautepierre 2, CHU de Strasbourg, avenue Molière, 67000 Strasbourg, France; Pole de santé publique, secteur méthodologie et biostatistiques, hôpitaux universitaires de Strasbourg, 1, place de l'Hôpital, 67000 Strasbourg, France
| | - Maxime Antoni
- Service de chirurgie du membre supérieur, hôpital de Hautepierre 2, CHU de Strasbourg, avenue Molière, 67000 Strasbourg, France.
| | - Philippe Clavert
- Service de chirurgie du membre supérieur, hôpital de Hautepierre 2, CHU de Strasbourg, avenue Molière, 67000 Strasbourg, France
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Werthel JD, Godenèche A, Antoni M, Valenti P, Chelli M, Nové-Josserand L, Bonnevialle N. Revision rotator cuff repair: can a Sugaya III tendon considered to be healed or not. J Shoulder Elbow Surg 2024; 33:255-262. [PMID: 37506999 DOI: 10.1016/j.jse.2023.06.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2023] [Revised: 06/14/2023] [Accepted: 06/21/2023] [Indexed: 07/30/2023]
Abstract
BACKGROUND Sugaya et al described a classification system to assess postoperative rotator cuff tendon healing. Although Sugaya I and II tendons can be considered as healed and Sugaya type IV and V can be considered as retorn, the exact status of Sugaya III tendons remains unclear. The objective of this study was to evaluate the impact of Sugaya III tendons on postoperative functional scores in a population of patients undergoing revision rotator cuff repair. METHODS We retrospectively studied the records of all patients who underwent revision rotator cuff repair in one of 12 different institutions between July 2001 and December 2020. A total of 203 shoulders were included (59% males, mean age: 51 ± 8 years old, mean follow-up 11.5 years [range: 2-28.8 yr]). Fifty-four patients (61% males, mean age 52 ± 6 years old, mean follow-up 14.1 years [range: 10.4-28.8 yr]) had a follow-up ≥10 years (mean 14.1 years [range: 10.4-28.8 yr]) and were included in a long-term follow-up subgroup analysis. Structural integrity of the repaired tendon was evaluated on magnetic resonance imaging at last follow-up. Functional scores, acromiohumeral index (AHI), and progression of fatty infiltration and of osteoarthritis were compared according to Sugaya type. RESULTS Mean Constant score and mean strength were significantly higher in Sugaya I and II tendons than in Sugaya III (P = .021 and .003) and Sugaya IV and V tendons (P = .07 and .038), but did not differ between Sugaya III and Sugaya IV and V tendons. Mean Subjective Shoulder Value, pain, AHI were significantly higher and fatty infiltration and progression in the Hamada classification were significantly lower in Sugaya I and II tendons and in Sugaya III than in Sugaya IV and V tendons (P < .05), but did not differ between Sugaya I and II and Sugaya III tendons. Similar characteristics could also be observed in the long-term follow-up subgroup. CONCLUSION Sugaya III tendons after revision rotator cuff repair do not allow restoration of strength thereby impacting the Constant score. However, there seems to be a protective effect of Sugaya III tendons with regard to pain, progression of proximal migration of the humeral head, osteoarthritis, and fatty infiltration, which seems to last at long-term follow-up.
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Affiliation(s)
- Jean-David Werthel
- Orthopedic Department, Hôpital Ambroise Paré, Boulogne-Billancourt, France.
| | - Arnaud Godenèche
- Ramsay Générale de Santé, Jean Mermoz Private Hospital, Centre Orthopédique Santy, Lyon, France
| | - Maxime Antoni
- Orthopedic Department, CHU de Strasbourg, Strasbourg, France
| | | | - Mikael Chelli
- Institut de Chirurgie Réparatrice, Groupe Kantys, Nice, France
| | - Laurent Nové-Josserand
- Ramsay Générale de Santé, Jean Mermoz Private Hospital, Centre Orthopédique Santy, Lyon, France
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Bratos M, Kolaj-Robin O, Antoni M, Charton E. Ph. Eur. testing for histamine and depressor substances using guinea-pigs and cats: the end of an era. Strategy for removal of animal tests for histamine and depressor substances and their vestiges from the Ph. Eur. Pharmeur Bio Sci Notes 2024; 2024:12-26. [PMID: 38533690] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 03/28/2024]
Abstract
For more than 50 years, in vivo assays have been used for testing pharmaceutical product safety due to their assumed ability to broadly detect potential unidentified contaminants. As part of these in vivo tests, the animal tests for depressor substances and histamine have been described in the European Pharmacopoeia since its first edition in 1977. Both tests measure the effect of histamine and histamine-like substances, using guinea-pigs and cats respectively. In 2024, the Histamine (2.6.10) general chapter is referenced in the Production section of four monographs and 10 monographs have variations of a sentence on designing the manufacturing process to eliminate or minimise substances lowering blood pressure in this same section, without referencing the chapter. The Depressor substances (2.6.11) chapter is referenced only in the Histamine (2.6.10) chapter as a next step if the histamine test is invalid. A historical search was performed and it has shown that the tests for histamine and for depressor substances were introduced by different groups of experts in an inconsistent way at different times, and for different reasons, leading to non-harmonised approaches across monographs. The control of histamine and other depressor substances has been the subject of numerous debates where their use was questioned. During these discussions, reports on positive cases or batches failing the test for histamine or depressor substances were anecdotal. In addition, in vivo tests can be considered non-specific, very variable, time-consuming, costly and ethically doubtful. More importantly, the majority of in vivo methods originate from a time when good manufacturing practice was not widely used and formal method validation requirements were not yet established. In view of the above, the removal of all references to animal tests for histamine or depressor substances from all texts still referring to them is proposed. Since the sentences in the Production section referring to the control of "substances lowering blood pressure", "vasoactive substances" or "hypotensive substances" appeared as remainders of the animal test without further guarantee of safety, it will also be proposed to remove all these sentences from the concerned monographs. Ultimately, the suppression of general chapters 2.6.10 and 2.6.11 from the Ph. Eur. is envisaged. Independently from the above, it is also envisaged to elaborate a new general chapter Histamine in active substances (2.5.47) to include physicochemical or immunochemical methods enabling the detection of histamine. This new text would aim at supporting manufacturers in their histamine control strategy following the inclusion of precaution statements in the general monograph on Products of fermentation (1468); these statements had been added in Ph. Eur. Supplements 9.6 and 10.4, following adverse events related to a GMP issue with gentamicin sulfate. This strategy has been endorsed by the European Pharmacopoeia Commission at its 177th Session in November 2023. The concerned monographs would be a subject of public consultation in Pharmeuropa 36.2 (April 2024).
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Affiliation(s)
- M Bratos
- European Directorate for the Quality of Medicines & HealthCare, European Pharmacopoeia Department (EPD), Council of Europe, Strasbourg, France
| | - O Kolaj-Robin
- European Directorate for the Quality of Medicines & HealthCare, European Pharmacopoeia Department (EPD), Council of Europe, Strasbourg, France
| | - M Antoni
- European Directorate for the Quality of Medicines & HealthCare, European Pharmacopoeia Department (EPD), Council of Europe, Strasbourg, France
| | - E Charton
- European Directorate for the Quality of Medicines & HealthCare, European Pharmacopoeia Department (EPD), Council of Europe, Strasbourg, France
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Villatte G, Soleilhavoup M, Antoni M, Marcheix PS, Pereira B, Boisgard S, Descamps S, Erivan R. Assessment and trends in the methodological quality of the top 50 most cited articles in shoulder arthroplasty. Orthop Traumatol Surg Res 2023; 109:103702. [PMID: 37827452 DOI: 10.1016/j.otsr.2023.103702] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Revised: 05/24/2023] [Accepted: 09/19/2023] [Indexed: 10/14/2023]
Abstract
INTRODUCTION Shoulder arthroplasty is increasingly frequent, and the associated literature is abundant. Citation rate is often considered a good means of assessing impact and scientific value. However, analysis of methodological quality is also essential in evidence-based medicine. OBJECTIVES (1) To identify the 50 most cited articles on shoulder arthroplasty, and (2) to assess the correlation between citation rate and methodological quality. The study hypothesis was that there is no correlation between citation rate and methodological quality. METHOD Articles were retrieved from PubMed and Google Scholar, identifying the 50 most cited articles on shoulder arthroplasty via the keywords "shoulder joint replacement", "shoulder arthroplasty", "anatomic shoulder prothesis", "reverse shoulder prothesis", and "glenohumeral arthritis". Modified Coleman Methodology Score (MCMS) and the Methodological Index for Non-Randomized Studies (MINORS) were calculated. RESULTS Mean citation rate for the 50 articles was 312.4±169.5 (range, 151-841.5), with a mean citation density of 18.8±10.6 (range, 4.7-46.7). 56% of the studies (28/50) were retrospective case series with level of evidence IV. There was no correlation between citation rate and methodological quality. DISCUSSION The 50 most cited articles on shoulder arthroplasty mostly showed low levels of methodological quality. There was no correlation between citation rate and methodological quality: the literature needs to be read with a critical eye. LEVEL OF EVIDENCE IV.
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Affiliation(s)
- Guillaume Villatte
- CHU de Clermont-Ferrand, CNRS, SIGMA Clermont, ICCF, université Clermont-Auvergne, 63000 Clermont-Ferrand, France; Service d'orthopédie-traumatologie. CHU de Montpied Clermont-Ferrand, 63000 Clermont-Ferrand, France.
| | - Marion Soleilhavoup
- Service d'orthopédie-traumatologie. CHU de Montpied Clermont-Ferrand, 63000 Clermont-Ferrand, France
| | - Maxime Antoni
- Centre orthopédique de l'orangerie, clinique de l'orangerie, 29, allée de la Robertsau, 67000 Strasbourg, France
| | - Pierre-Sylvain Marcheix
- Service de chirurgie orthopédique et traumatologique, CHU de Limoges, 2, avenue Martin-Luther-King, 87042 Limoges cedex, France
| | - Bruno Pereira
- Department of Clinical Research and Innovation (DRCI), CHU de Montpied Clermont-Ferrand, 63000 Clermont-Ferrand, France
| | - Stéphane Boisgard
- CHU de Clermont-Ferrand, CNRS, SIGMA Clermont, ICCF, université Clermont-Auvergne, 63000 Clermont-Ferrand, France; Service d'orthopédie-traumatologie. CHU de Montpied Clermont-Ferrand, 63000 Clermont-Ferrand, France
| | - Stéphane Descamps
- CHU de Clermont-Ferrand, CNRS, SIGMA Clermont, ICCF, université Clermont-Auvergne, 63000 Clermont-Ferrand, France; Service d'orthopédie-traumatologie. CHU de Montpied Clermont-Ferrand, 63000 Clermont-Ferrand, France
| | - Roger Erivan
- CHU de Clermont-Ferrand, CNRS, SIGMA Clermont, ICCF, université Clermont-Auvergne, 63000 Clermont-Ferrand, France; Service d'orthopédie-traumatologie. CHU de Montpied Clermont-Ferrand, 63000 Clermont-Ferrand, France
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Dujeux C, Antoni M, Thery C, Eichler D, Meyer N, Clavert P. History of mood and anxiety disorders does not affect the outcomes of arthroscopic rotator cuff repair. Orthop Traumatol Surg Res 2023; 109:103550. [PMID: 36642405 DOI: 10.1016/j.otsr.2023.103550] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Revised: 10/21/2022] [Accepted: 11/15/2022] [Indexed: 01/15/2023]
Abstract
BACKGROUND A pre-existing mood and anxiety disorder (MAD) is often present in patients with rotator cuff pathology, but its presumed negative effect on the outcomes has not been demonstrated. AIM OF STUDY AND HYPOTHESIS The primary objective of this study was to evaluate how a history of MAD affects the clinical outcomes 1 year after arthroscopic rotator cuff repair (RCR). The secondary objectives were to evaluate how a history of MAD affects tendon healing, analgesic consumption and the occurrence of complications. MATERIALS AND METHODS The study population consisted of 219 patients (mean age 54.5±6.6 years) who underwent arthroscopic repair for a distal supraspinatus tendon tear, with 17% (38/219) presenting an history of MAD (depression, unspecified mood disorder, anxiety, and bipolar disorder). Using univariate and multivariate analyses, the joint range of motion, Constant score, analgesic consumption, occurrence of complications during the first postoperative year and tendon healing at 1 year (MRI or CT arthrography) were compared between the two groups (with or without MAD). RESULTS The Constant score was lower preoperatively in patients with history of MAD (-4 points, p=.04) but there were no significant differences between the two groups at the various postoperative follow-up time points (p>.05). No significant difference was found between the two groups of patients in their analgesic consumption at the various postoperative time points (p>.05), tendon healing at 1 year (p=.17) or the occurrence of postoperative complications (p=.59). DISCUSSION/CONCLUSION Pre-existing MAD had no effect on the clinical outcomes after arthroscopic RCR at 1 year and no effect on tendon healing, analgesic consumption or the occurrence of complications in our study population. LEVEL OF EVIDENCE III; retrospective case-control study.
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Affiliation(s)
- Clément Dujeux
- Service de chirurgie du membre supérieur, hôpital de Hautepierre 2 - CHU Strasbourg, avenue Molière, 67000 Strasbourg, France
| | - Maxime Antoni
- Service de chirurgie du membre supérieur, hôpital de Hautepierre 2 - CHU Strasbourg, avenue Molière, 67000 Strasbourg, France.
| | - Charles Thery
- Service de chirurgie du membre supérieur, hôpital de Hautepierre 2 - CHU Strasbourg, avenue Molière, 67000 Strasbourg, France
| | - David Eichler
- Service de chirurgie du membre supérieur, hôpital de Hautepierre 2 - CHU Strasbourg, avenue Molière, 67000 Strasbourg, France
| | - Nicolas Meyer
- Service de chirurgie du membre supérieur, hôpital de Hautepierre 2 - CHU Strasbourg, avenue Molière, 67000 Strasbourg, France; Pôle de santé publique, secteur méthodologie et biostatistiques, hôpitaux universitaires de Strasbourg, 1, place de l'hôpital, 67000 Strasbourg, France
| | - Philippe Clavert
- Service de chirurgie du membre supérieur, hôpital de Hautepierre 2 - CHU Strasbourg, avenue Molière, 67000 Strasbourg, France
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El Amiri L, Clavert P, Gaudias J, Klein S, Rondé Oustau C, Antoni M. High infection control rate after systematic one-stage procedure for shoulder arthroplasty chronic infection. Int Orthop 2023; 47:2809-2826. [PMID: 37612523 DOI: 10.1007/s00264-023-05927-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/27/2023] [Accepted: 07/31/2023] [Indexed: 08/25/2023]
Abstract
PURPOSE The two stage revision procedure is the gold standard surgical technique in chronic shoulder periprosthetic joint infection (PJI). Series of one stage revision have been published with similar outcomes but with preoperative selection of patients. The aim of this work was to report the outcomes (infection eradication, functional, and radiographic) after systematic one stage revision, without preoperative selection of patients, in chronic shoulder PJI. METHODS This was a retrospective monocentric study including 40 patients (14 women and 26 men) with a diagnosis of periprosthetic joint infection after a shoulder arthroplasty. A one stage shoulder prosthesis revision was performed in all patients, for a PJI evolving for more than three weeks, without preoperative patient selection. The primary endpoint was the absence of signs of persistent infection at a minimum follow-up of two years. Secondary endpoints were clinical and radiological outcomes. RESULTS At the last follow-up, 36/40 patients had no recurrence of infection after the one stage revision, i.e., 90% of our series. In 45% (18/40) of the cases, the microbial organism was not known at the time of the one stage revision. Cutibacterium acnes was the most frequent pathogen, found in 67.5% (27/40) of the patients. The infection was polymicrobial in 40% (16/40) of the cases. At last follow-up, mean absolute Constant score was 48.4% (16-93) and weighted score was 65.5% (22-100), and satisfaction was evaluated by the patients as excellent or good in 75% (30/40). About 20% (8/40) of the patients had a postoperative complication. CONCLUSION A one stage revision procedure, combined with appropriate antibiotic therapy, made it possible to eradicate the PJI in 90% of the shoulders in our series with satisfactory functional outcomes.
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Affiliation(s)
- Laëla El Amiri
- Shoulder and Elbow Surgery Department, Hautepierre Hospital 2 - CHU Strasbourg, Avenue Molière, 67000, Strasbourg, France
| | - Philippe Clavert
- Shoulder and Elbow Surgery Department, Hautepierre Hospital 2 - CHU Strasbourg, Avenue Molière, 67000, Strasbourg, France
| | - Jeannot Gaudias
- Department of Orthopedic Septic Surgery, University Hospitals of Strasbourg, 1 place de l'hôpital, 67000, Strasbourg, France
| | - Stéphane Klein
- Department of Orthopedic Septic Surgery, University Hospitals of Strasbourg, 1 place de l'hôpital, 67000, Strasbourg, France
| | - Cécile Rondé Oustau
- Department of Orthopedic Septic Surgery, University Hospitals of Strasbourg, 1 place de l'hôpital, 67000, Strasbourg, France
| | - Maxime Antoni
- Shoulder and Elbow Surgery Department, Hautepierre Hospital 2 - CHU Strasbourg, Avenue Molière, 67000, Strasbourg, France.
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Thery C, Antoni M, Dujeux C, Eichler D, Meyer N, Clavert P. Increased operative time has a negative impact on clinical outcome in arthroscopic rotator cuff repair. Eur J Orthop Surg Traumatol 2023; 33:2865-2871. [PMID: 36879163 DOI: 10.1007/s00590-023-03487-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Accepted: 02/05/2023] [Indexed: 03/08/2023]
Abstract
BACKGROUND Few data are available about the impact of operative time on outcome of rotator cuff repair. AIM The aim of this study was to evaluate the impact of operative time on clinical outcome and tendon healing after arthroscopic rotator cuff repair. METHODS Patients operated on for distal supraspinatus tear in our institution between 2012 and 2018 were included retrospectively. Operative time, from skin incision until skin closure, was extracted from medical files. For statistical analysis, operative time was treated as a quantitative variable. Endpoints were clinical outcome (Constant score, range of motion), tendon healing (on CT or MRI) and complications at 1 year. The significance threshold was set at p = 0.05. RESULTS A total of 219 Patients, with a mean age of 54.6 years (range 40-70 years), were included. Mean operative time 44.9 min (range 14-140 min). Significant correlations (p < 0.05) were found for Constant score and external rotation at 1 year: increasing operative time by 1 min led to a decrease in Constant score of 0.115 points, or 6.9 points for a 60-min increase (p = 0.0167) and a decrease in external rotation of 0.134°, or 8.04° for a 60-min increase (p = 0.0214). No significant correlations were found for anterior elevation at 1 year (p = 0.2577), tendon healing at 1 year (p = 0.295) or onset of complications during follow-up (p = 0.193). DISCUSSION The minimal clinically important difference in Constant score in patients undergoing rotator cuff surgery is between 6 and 10 points. An increase of more than 60 min in operative time significantly impacted clinical outcome of arthroscopic distal supraspinatus repair, but not tendon healing. LEVEL OF EVIDENCE Level III: Retrospective Cohort Design. Therapeutic Study.
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Affiliation(s)
- Charles Thery
- Service de Chirurgie du Membre Supérieur, Pôle de Chirurgie Orthopédique et de Traumatologie, Hôpital Hautepierre 2 - CHU Strasbourg, Avenue Molière, 67000, Strasbourg, France
| | - Maxime Antoni
- Service de Chirurgie du Membre Supérieur, Pôle de Chirurgie Orthopédique et de Traumatologie, Hôpital Hautepierre 2 - CHU Strasbourg, Avenue Molière, 67000, Strasbourg, France.
| | - Clément Dujeux
- Service de Chirurgie du Membre Supérieur, Pôle de Chirurgie Orthopédique et de Traumatologie, Hôpital Hautepierre 2 - CHU Strasbourg, Avenue Molière, 67000, Strasbourg, France
| | - David Eichler
- Service de Chirurgie du Membre Supérieur, Pôle de Chirurgie Orthopédique et de Traumatologie, Hôpital Hautepierre 2 - CHU Strasbourg, Avenue Molière, 67000, Strasbourg, France
| | - Nicolas Meyer
- Pole de Santé Publique, Secteur Méthodologie et Biostatistiques, Hôpitaux Universitaires de Strasbourg, 1 Place de l'Hôpital, 67000, Strasbourg, France
| | - Philippe Clavert
- Service de Chirurgie du Membre Supérieur, Pôle de Chirurgie Orthopédique et de Traumatologie, Hôpital Hautepierre 2 - CHU Strasbourg, Avenue Molière, 67000, Strasbourg, France
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Antoni M, Bruyere A, Meyer N, Clavert P. Radial neck osteolysis after radial head replacement: Functional impact and risk factors. Orthop Traumatol Surg Res 2023; 109:103291. [PMID: 35470120 DOI: 10.1016/j.otsr.2022.103291] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2020] [Revised: 02/23/2021] [Accepted: 03/09/2021] [Indexed: 02/03/2023]
Abstract
INTRODUCTION Onset of radial neck osteolysis (RNO) has been reported after radial head replacement (RHR), but data are sparse regarding impact and risk factors. We therefore conducted a retrospective study, 1) to quantify RNO after RHR, 2) to assess clinical and radiological impact, and 3) to identify risk factors. HYPOTHESIS RNO prevalence is high, but functional impact is limited. MATERIAL AND METHOD A single-center retrospective study included all patients undergoing RHR for acute radial head fracture between 2008 and 2017: 53 patients, with a mean age of 53.8±15.7 years [range, 21-85 years]. At a minimum 2 years' follow-up, patients were assessed clinically on joint range of motion and Mayo Elbow Performance Score (MEPS) and radiologically on standard radiographs. Associations between RNO and various parameters were assessed. RESULTS At a mean 46.7±19.8 months' follow-up [range, 24-84 months], RNO was found in 54.7% of cases (29/53), with mean 4.0 ±2.8mm distal extension [range, 1.2-13.4mm], corresponding to 13.4±7.3% of stem height [range, 2.7-27.7%]. RNO at last follow-up was not significantly associated with reduced flexion-extension (121.9° versus 114.0°; p=0.11), pronation-supination (152.6° versus 138.3°; p=0.25) or MEPS (84.7 versus 84.8; p=0.97), or with higher rates of postoperative complications (11/29 (37.9%) versus 7/24 (29.2%); p=0.782) or surgical revision (11/29 (37.9%) versus 10/24 (41.7%); p=0.503). RNO was significantly associated with cementless fixation (19/29 (65.5%) versus 7/24 (29.2%); p=0.01), unipolar prosthesis (21/29 (72.4%) versus 7/24 (29.2%); p=0.002), high filling-ratio, whether proximal (88% versus 77%; p=0.002), middle (84% versus 75%; p=0.007) or distal (69% versus 59%; p=0.032), and shorter radial stem (33.2mm versus 46.3mm; p=0.011). No demographic parameters showed significant association with RNO at last follow-up. CONCLUSION RNO was frequent after RHR, but without clinical or radiological impact in the present series. The risk factors identified here argue for involvement of stress shielding. LEVEL OF EVIDENCE IV, cohort study.
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Affiliation(s)
- Maxime Antoni
- Service de Chirurgie du Membre Supérieur, Pôle de Chirurgie Orthopédique et de Traumatologie, Hôpital Hautepierre 2 - CHU Strasbourg, Avenue Molière, 67000 Strasbourg, France.
| | - Alexandra Bruyere
- Service de Chirurgie du Membre Supérieur, Pôle de Chirurgie Orthopédique et de Traumatologie, Hôpital Hautepierre 2 - CHU Strasbourg, Avenue Molière, 67000 Strasbourg, France
| | - Nicolas Meyer
- Pole de Santé Publique, Secteur Méthodologie et Biostatistiques, Hôpitaux Universitaires de Strasbourg, 1, place de l'Hôpital, 67000 Strasbourg, France
| | - Philippe Clavert
- Service de Chirurgie du Membre Supérieur, Pôle de Chirurgie Orthopédique et de Traumatologie, Hôpital Hautepierre 2 - CHU Strasbourg, Avenue Molière, 67000 Strasbourg, France
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Himer N, Antoni M, Soares S, Brinkert D, Marco AD. Total Scapular Prosthesis, an Option for the Treatment of Scapular Chondrosarcoma. J Orthop Case Rep 2023; 13:111-116. [PMID: 37654767 PMCID: PMC10465740 DOI: 10.13107/jocr.2023.v13.i08.3838] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2023] [Revised: 06/16/2023] [Indexed: 09/02/2023] Open
Abstract
Introduction Chondrosarcoma has the highest prevalence among the primary malignant bone tumors in adults over the age of 50, and the scapular region is the most affected anatomical site. Case Report We report the case of a 66-year-old female patient, with no previous medical history, who consulted for aggravating mixed, non-specific, and atraumatic pain in the right shoulder, evolving for a year. The radiological assessment, including a computed tomography (CT) scan, a magnetic resonance imaging, and a tumor CT-guided biopsy, confirmed the diagnosis of a Grade 2 chondrosarcoma. A curative surgical treatment was performed, by an extended tumor resection and simultaneous joint reconstruction by a reversed total shoulder prosthesis with a custom-made total scapular prosthesis. This option allows to maintain survival prognosis, associated with the preservation of upper limb function. Conclusion The results were conclusive at the curative level and very encouraging from the functional point of view with progressive and partial recovery of the articular amplitudes, allowing the preservation of patient's autonomy and quality of life. No complications such as scapular dislocation or tumor recurrence were documented at 3-year postoperative follow-up.
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Affiliation(s)
- Nabile Himer
- Oncologic Orthopaedic Surgery Unit and Upper Limb Surgery Unit, Strasbourg University Hospital, France
| | - Maxime Antoni
- Oncologic Orthopaedic Surgery Unit and Upper Limb Surgery Unit, Strasbourg University Hospital, France
| | - Sérgio Soares
- Department of Orthopaedic Surgery and Traumatology, HFR Hôpital Fribourgeois, Switzerland
| | - David Brinkert
- Oncologic Orthopaedic Surgery Unit and Upper Limb Surgery Unit, Strasbourg University Hospital, France
| | - Antonio Di Marco
- Oncologic Orthopaedic Surgery Unit and Upper Limb Surgery Unit, Strasbourg University Hospital, France
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Baldairon F, Antoni M, Le Thai V, Clavert P. Is early mobilization a viable option after intramedullary nailing of 4-parts proximal humerus fractures? Eur J Orthop Surg Traumatol 2023:10.1007/s00590-023-03478-1. [PMID: 36715762 DOI: 10.1007/s00590-023-03478-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Accepted: 01/18/2023] [Indexed: 01/31/2023]
Abstract
INTRODUCTION After centromedullary nailing (CMN) of 4-parts (4P) cephalo-tuberositary fractures of the proximal humerus (PH), shoulder immobilization for a few weeks is usual, although no scientific justification does support this attitude, nor the duration of immobilization. The objective of this study was to assess the impact of early mobilization after CMN of PH 4P fractures on clinical, radiological outcomes and complication rates. The hypothesis was that early mobilization would not lead to a deterioration in results or an increase in the complication rate. MATERIALS AND METHODS All patients operated on for a 4P-PH fracture by CMN in our institution between 2010 and 2018 were included retrospectively. 2 groups were formed according to the duration of post-operative immobilization of the shoulder: 0-2 weeks (group A) and 3-6 weeks (group B). All patients had a clinical examination (Range of motion ROM and Constant score) and X-rays of the shoulder at least 24 months of follow-up. 58 patients (average age 66 years (39-89)) were included, with 25 in group A and 33 in group B. RESULTS The average follow-up was 38.5 (24-73) months. The active ROM at the last follow-up was: active anterior elevation 149° (80°-180°) in group A versus 134 (60°-180°) in group B (p = 0.099); active external rotation 145° (15°-70°) in group A versus 42° (15-70°) in group B (p = 0.6). The Absolute Mean Constant score was 78.29 for Group A (45-100) versus 68.59 points (45-96) for Group B (p = 0.065). Regarding complications: in group A, we found 2 retractile capsulitis, 2 pseudarthrosis and 2 osteonecrosis of the humeral head. In group B, we found 5 retractile capsulitis, 1 infection of the surgical site, 3 osteonecrosis of the humeral head and 1 pseudarthrosis. CONCLUSION Early mobilization after CMN of 4P-PH fractures did not lead to an increase in the complications rate and in particular secondary displacements or osteonecrosis. There was a trend toward improved clinical outcomes with early mobilization, although this trend was not statistically significant. EVIDENCE LEVEL IV, retrospective study.
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Affiliation(s)
- Florent Baldairon
- Department of Upper Limb Surgery, CHU de Strasbourg, Avenue Molière, 67200, Strasbourg, France
| | - Maxime Antoni
- Department of Upper Limb Surgery, CHU de Strasbourg, Avenue Molière, 67200, Strasbourg, France.
| | - Vinh Le Thai
- Department of Upper Limb Surgery, CHU de Strasbourg, Avenue Molière, 67200, Strasbourg, France
| | - Philippe Clavert
- Department of Upper Limb Surgery, CHU de Strasbourg, Avenue Molière, 67200, Strasbourg, France
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Bruyere A, Ollivier I, Antoni M, Bodin F, Clavert P. Musculocutaneous flap of the medial head of the triceps brachii: pedicled flap to cover the posterior cubital region. Surg Radiol Anat 2022; 44:479-484. [DOI: 10.1007/s00276-022-02900-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Accepted: 01/28/2022] [Indexed: 11/25/2022]
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Clavert P, Antoni M. Shoulder arthrodesis in brachial plexus palsy. Hand Surg Rehabil 2021; 41S:S54-S57. [PMID: 34147669 DOI: 10.1016/j.hansur.2018.05.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/04/2018] [Revised: 05/03/2018] [Accepted: 05/20/2018] [Indexed: 11/26/2022]
Abstract
Long considered as the ultimate surgery for limb salvage in case of brachial plexus palsy, shoulder fusion has seen its indications reduced with the development of more numerous and multiple tendon transfers. This option remains valid and should always be suggested first because of its reliable effects on pain and function. However, it is a demanding surgery, the position of the fusion remains difficult to determine and the complication rate is not negligible.
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Affiliation(s)
- P Clavert
- Service de Chirurgie du Membre Supérieur, CHRU Strasbourg, 10, avenue Baumann, 67400 Illkirch-Graffenstaden, France.
| | - M Antoni
- Service de Chirurgie du Membre Supérieur, CHRU Strasbourg, 10, avenue Baumann, 67400 Illkirch-Graffenstaden, France
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Dauzere F, Clavert P, Ronde-Oustau C, Antoni M. Is systematic 1-stage exchange a valid attitude in chronic infection of total elbow arthroplasty? Orthop Traumatol Surg Res 2021; 107:102905. [PMID: 33789199 DOI: 10.1016/j.otsr.2021.102905] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/09/2019] [Revised: 03/03/2020] [Accepted: 05/11/2020] [Indexed: 02/03/2023]
Abstract
INTRODUCTION Surgical treatment for chronic infection of total elbow arthroplasty (TEA) generally involves 2-stage exchange. In the lower limb, 1-stage strategies are increasingly implemented, but few cases have been reported for the elbow. We present results in a preliminary series, with the aim of: (1) assessing control of infection in systematic 1-stage exchange for chronic TEA infection, (2) detailing clinical and radiological results, and (3) analyzing intra- and post-operative complications. HYPOTHESIS Systematic 1-stage exchange for chronic TEA prosthetic joint infection provides satisfactory control of infection. MATERIAL AND METHODS Seven non-selected patients were operated on by 1-stage exchange for chronic infection of TEA during the study period. Two died before the minimum 2 years' follow-up, from causes unrelated to the infection. Thus 5 patients (4 women, 1 man; mean age at surgery, 61 years [range: 48-69 years]) were included for analysis. At a minimum 2 years' follow-up, all underwent clinical examination and elbow X-ray. Infection was monomicrobial in 4 cases and polymicrobial in 1. Isolates comprised Staphylococcus aureus in 40% of cases (2/5), Staphylococcus epidermidis in 60% (3/5) and Staphylococcus Warneri in 20% (1/5). Three patients showed fistula. Three were under immunosuppression/immunomodulation treatment. RESULTS At a mean 40 months' follow-up (range: 24-60 months), 4 patients (80%) were free of infection and 1 showed signs of persistent infection. Mean range of flexion-extension was 81° (range: 60-95°) and pronation-supination 128° (range: 80-160°). Mean Mayo Elbow Performance Score was 75 points (range: 65-90). There were 2 intraoperative fractures and 1 neurologic deficit with partial regression. CONCLUSION One-stage exchange provided control of infection in 80% of cases, despite cutaneous fistulae or immunosuppression treatment. Clinical results and complications rate were similar to those reported for 2-stage exchange. LEVEL OF EVIDENCE IV; retrospective study without control group.
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Affiliation(s)
- Florence Dauzere
- Service de Chirurgie du Membre Supérieur, Hôpital de Hautepierre, Hôpitaux Universitaires de Strasbourg, 1, avenue Molière, 67098 Strasbourg cedex, France
| | - Philippe Clavert
- Service de Chirurgie du Membre Supérieur, Hôpital de Hautepierre, Hôpitaux Universitaires de Strasbourg, 1, avenue Molière, 67098 Strasbourg cedex, France
| | - Cécile Ronde-Oustau
- Service de Chirurgie Orthopédique Septique, Hôpital de Hautepierre, Hôpitaux Universitaires de Strasbourg, 1, avenue Molière, 67098 Strasbourg Cedex, France
| | - Maxime Antoni
- Service de Chirurgie du Membre Supérieur, Hôpital de Hautepierre, Hôpitaux Universitaires de Strasbourg, 1, avenue Molière, 67098 Strasbourg cedex, France.
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Hecht CL, Aarshati A, Miceli J, Olejniczac D, Peyser T, Geller DA, Antoni M, Kiefer G, Reyes V, Zandberg D, Johnson J, Nilsen M, Tohme S, Steel JL. Trait mindfulness and the mental and physical health of caregivers for individuals with cancer. Eur J Integr Med 2021; 44:101325. [PMID: 34149965 PMCID: PMC8211096 DOI: 10.1016/j.eujim.2021.101325] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Mindfulness plays a role in moderating the negative mental and physical health outcomes associated with caregiving. The aims of this study were to examine the relationship between trait mindfulness and the (1) psychological functioning, (2) health behaviors, (3) and physical health of caregivers for individuals diagnosed with cancer. METHODS Caregivers completed a battery of questionnaires and examinations assessing sociodemographic characteristics, trait mindfulness, depression, perceived stress, caregiver stress, sleep, diet, physical activity, tobacco use, alcohol use, blood pressure, and BMI. Demographics and cancer diagnostics were collected for the individuals whom caregivers supported. Linear regression, multivariate analyses, and moderator analyses were performed. RESULTS Of the 78 caregivers, the mean age was 63.9 (S.D.=13.1); 59% identified as female; 97% identified as White. Regression analyses indicated that caregivers who reported higher levels of trait mindfulness reported significantly less perceived stress (b= -4.38, SE= 0.88, p <.001), lower levels of depression (b= -3.74, SE= 1.10, p = .001), greater caregiver quality of life (b= -9.05, SE=2.12, p < .001), better sleep quality (b= -0.98, SE=0.44, p = 0.03), and lower rates of tobacco use (b= -10.12, SE= 3.43, p =.003). Trait mindfulness was not significantly related to diet, alcohol use, blood pressure, or BMI. CONCLUSIONS Higher levels of trait mindfulness are associated with positive mental and physical health measure for caregivers. Future research would benefit from further examining mindfulness-based interventions and their impacts in mitigating the negative toll of caregiving in the context of cancer.
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Affiliation(s)
- C L Hecht
- University of Pittsburgh, School of Medicine Kaufmann Building, Suite 601
| | - A Aarshati
- University of Pittsburgh, School of Medicine Kaufmann Building, Suite 601
| | - J Miceli
- University of Pittsburgh, School of Medicine Kaufmann Building, Suite 601
| | - D Olejniczac
- University of Pittsburgh, School of Medicine Kaufmann Building, Suite 601
| | - T Peyser
- University of Pittsburgh, School of Medicine Kaufmann Building, Suite 601
| | - D A Geller
- University of Pittsburgh, School of Medicine Kaufmann Building, Suite 601
| | - M Antoni
- University of Miami Department of Psychology
| | - G Kiefer
- University of Pittsburgh Medical Center's Hillman Cancer Center
| | - V Reyes
- University of Pittsburgh Medical Center's Hillman Cancer Center
| | - D Zandberg
- University of Pittsburgh Medical Center's Hillman Cancer Center
| | - J Johnson
- University of Pittsburgh Medical Center's Hillman Cancer Center
| | - M Nilsen
- University of Pittsburgh Medical Center's Hillman Cancer Center
| | - S Tohme
- University of Pittsburgh School of Nursing
| | - J L Steel
- University of Pittsburgh, School of Medicine Kaufmann Building, Suite 601
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Antoni M, Ginot G, Mereb T, Clement X, Eichler D, Kempf JF, Clavert P. Post-traumatic elbow osteoarthritis after radial head arthroplasty: Prevalence and risk factors. Orthop Traumatol Surg Res 2021; 107:102814. [PMID: 33482405 DOI: 10.1016/j.otsr.2021.102814] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2019] [Revised: 03/02/2020] [Accepted: 03/18/2020] [Indexed: 02/03/2023]
Abstract
BACKGROUND One of the treatment options for comminuted radial head fractures is radial head arthroplasty (RHA), especially when the elbow is also dislocated. While the clinical outcomes of RHA have been well documented, the incidence of post-traumatic osteoarthritis after RHA and its risk factors are not well known. OBJECTIVE To determine the incidence of post-traumatic elbow osteoarthritis (humeroulnar and humeroradial joints) after RHA and identify its risk factors. METHODS All patients who underwent RHA at our hospital between 2008 and 2016 were included retrospectively. The inclusion criteria were primary RHA, recent radial head fracture (isolated or associated with elbow dislocation), minimum 1 year of follow-up, clinical and radiographic examination at final assessment. The exclusion criteria were pre-existing elbow osteoarthritis, RHA revision, multiple fractures of the ipsilateral upper limb or polytrauma. The final assessment consisted of a clinical examination [joint range of motion (ROM) and Mayo Elbow Performance Score (MEPS)] and standard radiographs. The correlation between the incidence and severity of osteoarthritis and various risk factors was determined. RESULTS Seventy-three patients were included in the analysis with a mean age of 56 years (21-85). The injuries consisted of 41 terrible triad, 15 isolated radial head fractures, 11 Monteggia fractures and 6 transolecranon fracture-dislocations. The mean follow-up was 3.4 years (1-10.9). At the final assessment, osteoarthritis was visible in the humeroulnar compartment in 56% of cases and in the humeroradial compartment in 72% of cases. There was a statistical correlation between the presence of humeroulnar osteoarthritis at the final assessment and ROM in flexion-extension (p=0.003), MEPS (p<0.001), duration of immobilization (p=0.03) and presence of posterior subluxation on immediate postoperative radiographs (p=0.012). The correlation between humeroradial osteoarthritis at the final assessment and ROM in flexion-extension (p=0.0054), RHA implant position (p<0.01), and unipolar configuration (p=0.027) was statistically significant. CONCLUSION In our study, elbow osteoarthritis incidence after RHA was 56% in the humeroulnar joint and 72% in the humeroradial joint. RHA implant placement, posterior subluxation immediately postoperative and the duration of immobilization were significantly corelated with osteoarthritis. LEVEL OF EVIDENCE IV; case series without control group.
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Affiliation(s)
- Maxime Antoni
- Service de Chirurgie du Membre Supérieur, Pôle de Chirurgie Orthopédique et de Traumatologie, Hôpital Hautepierre 2 - CHU Strasbourg, Avenue Molière, 67000 Strasbourg, France.
| | - Geoffrey Ginot
- Service de Chirurgie du Membre Supérieur, Pôle de Chirurgie Orthopédique et de Traumatologie, Hôpital Hautepierre 2 - CHU Strasbourg, Avenue Molière, 67000 Strasbourg, France
| | - Thomas Mereb
- Service de Chirurgie du Membre Supérieur, Pôle de Chirurgie Orthopédique et de Traumatologie, Hôpital Hautepierre 2 - CHU Strasbourg, Avenue Molière, 67000 Strasbourg, France
| | - Xavier Clement
- Service de Chirurgie du Membre Supérieur, Pôle de Chirurgie Orthopédique et de Traumatologie, Hôpital Hautepierre 2 - CHU Strasbourg, Avenue Molière, 67000 Strasbourg, France
| | - David Eichler
- Service de Chirurgie du Membre Supérieur, Pôle de Chirurgie Orthopédique et de Traumatologie, Hôpital Hautepierre 2 - CHU Strasbourg, Avenue Molière, 67000 Strasbourg, France
| | - Jean-François Kempf
- Service de Chirurgie du Membre Supérieur, Pôle de Chirurgie Orthopédique et de Traumatologie, Hôpital Hautepierre 2 - CHU Strasbourg, Avenue Molière, 67000 Strasbourg, France
| | - Philippe Clavert
- Service de Chirurgie du Membre Supérieur, Pôle de Chirurgie Orthopédique et de Traumatologie, Hôpital Hautepierre 2 - CHU Strasbourg, Avenue Molière, 67000 Strasbourg, France
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Antoni M, Mereb T, Ginot G, Meyer N, Clavert P. Prognostic factors for traumatic elbow osteoarthritis after terrible triad surgery, and functional impact. Orthop Traumatol Surg Res 2021; 107:102826. [PMID: 33516892 DOI: 10.1016/j.otsr.2021.102826] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2020] [Revised: 09/18/2020] [Accepted: 09/23/2020] [Indexed: 02/03/2023]
Abstract
INTRODUCTION Terrible triad (TT) of the elbow almost always requires surgery to prevent progression to chronic instability and more or less inevitable osteoarthritis. Progression toward osteoarthritis after well-conducted surgery and associated risk factors have been little reported. We performed a retrospective study: (1) to assess rates of post-traumatic elbow osteoarthritis after surgical treatment of TT; (2) to assess functional impact; and (3) to identify prognostic factors. HYPOTHESIS Prevalence of osteoarthritis after surgical treatment of TT is high, impairing functional results. MATERIAL AND METHOD A single-center retrospective study included 53 patients, with a mean age of 50±17.8 years (range, 21-84 years), undergoing surgery for acute TT in our department. All received clinical examination with ranges of motion and Mayo Elbow Performance Index (MEPI) and radiographic assessment at a minimum 1 year's follow-up. Osteoarthritis at last follow-up was assessed on elbow X-ray in the humero-ulnar and radio-condylar compartments on the Broberg-Morrey classification. Functional impact on range of motion and MEPI and prognostic factors were assessed on Student test or ANOVA and Chi2 or Fisher test. RESULTS Prevalence of Broberg-Morrey grade 2 or 3 osteoarthritis was 45.3% (24/53) in the humero-ulnar compartment and 50% (25/50) in the radio-condylar compartment. Humero-ulnar osteoarthritis impaired MEPI (76.3 points with versus 88.4 points without; p=0.003), flexion-extension (102.3° versus 115.2°; p=0.043) and pronation-supination (138.8° versus 159.3°; p=0.006). Radio-condylar osteoarthritis had no significant impact on MEPI (81.4 points with and 84.4 points without; p=0.47), flexion-extension (104.8° and 113°; p=0.23) or pronation-supination (141.8° and 156.4°; p=0.2). Humero-ulnar osteoarthritis at last follow-up was associated with dislocation or subluxation on immediate postoperative lateral view (45.8% with versus 10.3% without; p=0.004) and at last follow-up (20.8% versus 3.4%; p=0.047) and with postoperative complications (54.2% and 27.6%; p=0.049). Radio-condylar osteoarthritis at last follow-up was associated with radial head replacement rather than internal fixation (respectively, 92% and 48%; p=0.0007) and excessively high radial head implant positioning (47.8% versus 0%; p=0.023). CONCLUSION Prevalence of traumatic osteoarthritis after TT surgery was high, at 45.3% in the humero-ulnar compartment and 50% in the radio-condylar compartment, with clinical impact in humero-ulnar involvement. LEVEL OF EVIDENCE IV; cohort study without control group.
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Affiliation(s)
- Maxime Antoni
- Pôle de chirurgie orthopédique et de traumatologie, service de chirurgie du membre supérieur, CHU de Strasbourg, Hôpital Hautepierre 2, avenue Molière, 67000 Strasbourg, France.
| | - Thomas Mereb
- Pôle de chirurgie orthopédique et de traumatologie, service de chirurgie du membre supérieur, CHU de Strasbourg, Hôpital Hautepierre 2, avenue Molière, 67000 Strasbourg, France
| | - Geoffrey Ginot
- Pôle de chirurgie orthopédique et de traumatologie, service de chirurgie du membre supérieur, CHU de Strasbourg, Hôpital Hautepierre 2, avenue Molière, 67000 Strasbourg, France
| | - Nicolas Meyer
- Pôle de santé publique, secteur méthodologie et biostatistiques, hôpitaux universitaires de Strasbourg, 1, place de l'Hôpital, 67000 Strasbourg, France
| | - Philippe Clavert
- Pôle de chirurgie orthopédique et de traumatologie, service de chirurgie du membre supérieur, CHU de Strasbourg, Hôpital Hautepierre 2, avenue Molière, 67000 Strasbourg, France
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Antoni M, Lazarus P, Kempf JF, Clavert P. Arthroscopic intramedullary nailing of humeral fractures through the rotator interval. Orthop Traumatol Surg Res 2021; 107:102750. [PMID: 33321228 DOI: 10.1016/j.otsr.2020.102750] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2019] [Revised: 05/03/2020] [Accepted: 06/02/2020] [Indexed: 02/03/2023]
Abstract
INTRODUCTION Antegrade nailing of humeral fractures is a proven technique with well-documented results. The standard surgical approach requires incision of the supraspinatus tendon to insert a nail, which comes with the risk of damaging the rotator cuff. The aims of this study were to describe a new surgical technique for arthroscopic humeral nailing that does not require opening the rotator cuff and to report the clinical and radiological outcomes of this technique. MATERIALS AND METHODS This was a single center, retrospective study of patients who had a humeral shaft or surgical neck fracture at our hospital in 2017 and underwent antegrade intramedullary nailing by arthroscopy. The nail was introduced through the rotator interval without opening the rotator cuff. All were reviewed at 1-year postoperative: clinical examination (joint range of motion and Constant score) plus AP and lateral radiographs of the shoulder. RESULTS Eighteen patients (12 women, 6 men) with a mean age of 65.4 years (37-84) were included retrospectively. One patient died during the follow-up period thus 17 patients were available for analysis. At the 1-year follow-up, the mean forward flexion was 152.1° (90-180), the mean external rotation was 56.1° (30-80), the mean absolute Constant score was 73.9 (54-88) points and the mean adjusted Constant score was 93.5 (67-100) points. Bone union was achieved in 16/17 patients (94%) with 1 patient experiencing a nonunion. There were no complications. CONCLUSION Arthroscopic antegrade nailing of humeral shaft and surgical neck fractures through the rotator interval yields good clinical and radiological results in our hands. This new, rotator cuff-sparing technique is a viable option for treating humeral fractures by arthroscopy. LEVEL OF EVIDENCE IV; retrospective study without control group.
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Affiliation(s)
- Maxime Antoni
- Service de chirurgie du membre supérieur, CHU de Strasbourg, Strasbourg, France.
| | - Priscille Lazarus
- Service de chirurgie du membre supérieur, CHU de Strasbourg, Strasbourg, France
| | - Jean-François Kempf
- Service de chirurgie du membre supérieur, CHU de Strasbourg, Strasbourg, France
| | - Philippe Clavert
- Service de chirurgie du membre supérieur, CHU de Strasbourg, Strasbourg, France
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Villatte G, Marcheix PS, Antoni M, Devos P, Descamps S, Boisgard S, Erivan R. Do bibliometric findings differ between Medline, Google Scholar and Web of Science? Bibliometry of publications after oral presentation to the 2013 and 2014 French Society of Arthroscopy (SFA) Congresses. Orthop Traumatol Surg Res 2020; 106:1469-1473. [PMID: 33153959 DOI: 10.1016/j.otsr.2020.09.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2020] [Revised: 09/08/2020] [Accepted: 09/09/2020] [Indexed: 02/03/2023]
Abstract
INTRODUCTION Bibliometrics consists in quantitative and qualitative analysis of an individual's or group's communication (volume, visibility), and impacts research funding. There are a number of bibliometric data sources, functioning in different ways and liable to give rise to differing statistics. This point has not been investigated in relation to publication following presentation to a French congress. We therefore conducted a study comparing the main bibliometric instruments, aiming to assess: (1) publication rates following oral presentation to the 2013 and 2014 French Society of Arthroscopy (SFA) Congresses according to the database used, and (2) citation rates for these publications according to database. HYPOTHESIS Publication and citation rates differ according to database. Material and method All 199 Abstracts of oral presentations to the 2013 and 2014 SFA Congresses were included. Based on author names and key-words, manual search was conducted in the Medline, Web of Science and Google Scholar databases. Publication characteristics (citation rate) were studied using the 3 databases and the French SIGAPS (Système d'Interrogation, de Gestion et d'Analyse des Publications Scientifiques: Scientific Publication Search, Management and Analysis System) website. RESULTS Publication rates according to Medline and Google Scholar were the same (48.2%: 96 articles for 199 presentations), but significantly lower on Web of Science (44.7%: 89/199; p=0.002). Citation rates differed significantly (p<0.001) between sources, with Google Scholar listing a mean 1.5-3.4-fold more citations per article than the other 2 databases. Citation rates between the 3 databases correlated strongly (r=0.93). DISCUSSION The example presented in this study illustrates the differences in bibliometrics found between different databases. There was a 4% difference (7/199 articles) in publication rates following oral presentation to an SFA Congress, and even greater differences in citation rates per article, with 1.5-3.4-fold more citations according to Google Scholar. Bibliometric studies need to acknowledge the database(s) being used, which should be as many as possible to enhance exhaustiveness. LEVEL OF EVIDENCE IV; descriptive epidemiologic study.
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Affiliation(s)
- Guillaume Villatte
- CNRS, SIGMA Clermont, ICCF, université Clermont Auvergne, CHU Clermont-Ferrand, 63000 Clermont-Ferrand, France; Service d'orthopédie-traumatologie, CHU Montpied Clermont-Ferrand, 63000 Clermont-Ferrand, France.
| | - Pierre-Sylvain Marcheix
- Service de chirurgie orthopédique et traumatologique, CHU de Limoges, 2, avenue Martin-Luther-King, 87042 Limoges cedex, France
| | - Maxime Antoni
- Service de chirurgie du membre supérieur, hôpitaux universitaires de Strasbourg, 1, avenue Molière, 67098 Strasbourg, France
| | - Patrick Devos
- ULR 2694 - METRICS : évaluation des technologies de santé et des pratiques médicales, université de Lille, CHU Lille, 59000 Lille, France
| | - Stéphane Descamps
- CNRS, SIGMA Clermont, ICCF, université Clermont Auvergne, CHU Clermont-Ferrand, 63000 Clermont-Ferrand, France; Service d'orthopédie-traumatologie, CHU Montpied Clermont-Ferrand, 63000 Clermont-Ferrand, France
| | - Stéphane Boisgard
- CNRS, SIGMA Clermont, ICCF, université Clermont Auvergne, CHU Clermont-Ferrand, 63000 Clermont-Ferrand, France; Service d'orthopédie-traumatologie, CHU Montpied Clermont-Ferrand, 63000 Clermont-Ferrand, France
| | - Roger Erivan
- CNRS, SIGMA Clermont, ICCF, université Clermont Auvergne, CHU Clermont-Ferrand, 63000 Clermont-Ferrand, France; Service d'orthopédie-traumatologie, CHU Montpied Clermont-Ferrand, 63000 Clermont-Ferrand, France
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Flurin PH, Antoni M, Métais P, Aswad R. Revision of failed Latarjet with the Eden-Hybinette surgical technique. Orthop Traumatol Surg Res 2020; 106:223-227. [PMID: 32173300 DOI: 10.1016/j.otsr.2019.12.009] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2018] [Revised: 10/11/2019] [Accepted: 12/02/2019] [Indexed: 02/03/2023]
Abstract
INTRODUCTION The outcomes of the Latarjet procedure for anterior shoulder instability are highly satisfactory although recurrences are possible. Surgical revision is challenging, and often requires an iliac crest bone graft as described by Eden and Hybinette. The aims of our study were to analyze the outcomes of the Eden-Hybinette technique after failed Latarjet procedure, determine the failure and complication rates, and analyze the risk of osteoarthritis. We hypothesized that the Eden-Hybinette technique would yield good outcomes after failed Latarjet procedure. MATERIAL AND METHODS Retrospective multicenter study (9 hospitals) by the French Shoulder and Elbow Society (SoFEC) involving 46 patients who underwent revision surgery with an Eden-Hybinette procedure after failed Latarjet stabilization. The patients had a minimum follow-up of 1year and the outcomes were evaluated based on the Rowe score, Walch-Duplay score and radiographs. RESULTS The mean age at the final assessment was 32years. The mean follow-up was 38 months and 86% of patients had a stable shoulder with an overall satisfaction rate of 80%. Postoperatively, the Rowe score averaged 76/100 and the Walch-Duplay score averaged 68/100; 60% of patients had resumed their sports participation. Return to sport was statistically correlated with age (p=0.0001), osteoarthritis (p=0.05) and time elapsed between the two surgical procedures (p=0.0001). The Rowe score was statistically correlated with osteoarthritis (p=0.01). DISCUSSION/CONCLUSION Our study is one of the largest on the Eden-Hybinette procedure for recurrent anterior shoulder instability. The outcomes at 3years' follow-up were satisfactory in 80% of patients and 86% had stable shoulders. The osteoarthritis rate was low (11%), although the follow-up period was relatively short. LEVEL OF EVIDENCE IV, non-randomized multicenter retrospective study.
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Affiliation(s)
- Pierre-Henri Flurin
- Clinique du Sport Bordeaux-Mérignac, 2-4, rue Negrevergne, 33700 Mérignac, France.
| | - Maxime Antoni
- Centre de Chirurgie Orthopédique et de la Main, CHU Strasbourg, avenue Achille-Baumann, 67400 Illkirch, France
| | - Pierre Métais
- Clinique de la Chataigneraie, 63110 Beaumont, France
| | - Richard Aswad
- Institut de Chirurgie Orthopédique et Sportive, 463 rue Paradis, 13008 Marseille, France
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- French Shoulder and Elbow Society (SoFEC), 34, rue du 11-novembre, 44110 Chateaubriant, France
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Antoni M, Kempf JF, Clavert P. Comparison of bipolar and monopolar radial head prostheses in elbow fracture-dislocation. Orthop Traumatol Surg Res 2020; 106:311-317. [PMID: 32173303 DOI: 10.1016/j.otsr.2019.10.027] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2019] [Revised: 09/27/2019] [Accepted: 10/11/2019] [Indexed: 02/03/2023]
Abstract
INTRODUCTION The role of bipolar radial head prostheses (RHP) in elbow fracture-dislocation is controversial, with some reports of poorer stabilization than with monopolar designs. The aim of the present study was to compare mono- versus bi-polar RHPs in elbow fracture-dislocation. The study hypothesis was that mono- and bi-polar RHPs do not differ in clinical and radiological results, complications or revision rates. MATERIAL AND METHODS A single-center retrospective study included 58 patients, with a mean age of 55 years (range, 21-84 years). All received RHP for elbow dislocation with association: terrible triad, Monteggia fracture-dislocation, transolecranal dislocation or divergent dislocation. Two groups were compared: Mono-RHP, with monopolar prosthesis (n=40), and Bi-RHP, with bipolar prosthesis (n=18). All patients underwent clinical and radiological examination at last follow-up. RESULTS Mean follow-up was 42.7 months (range, 12-131 months). There were no significant (p>0.05) inter-group differences in range of motion or Mayo Elbow Performance Score. Mono- versus bi-polar design did not correlate with onset of complications (p=0.89), surgical revision (p=0.71), persistent or recurrent instability (p=0.59), or ulnohumeral (p=0.62) or capitulum (p=0.159) osteoarthritis at last follow-up. DISCUSSION AND CONCLUSION No differences were found between mono- and bi-polar RHPs in the treatment of elbow fracture-dislocation. Clinical and radiographic results were similar, as were complications and revision rates. The literature is inconclusive, reporting contradictory conclusions. We see no contraindications to bipolar RHPs in elbow dislocation with association, notably terrible triad injury. LEVEL OF EVIDENCE III, Retrospective case-control study.
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Affiliation(s)
- Maxime Antoni
- Service de chirurgie du membre supérieur, Pôle de Chirurgie Orthopédique et de Traumatologie, hôpital de Hautepierre 2; CHU Strasbourg, 1, avenue Molière, 67200 Strasbourg, France.
| | - Jean-François Kempf
- Service de chirurgie du membre supérieur, Pôle de Chirurgie Orthopédique et de Traumatologie, hôpital de Hautepierre 2; CHU Strasbourg, 1, avenue Molière, 67200 Strasbourg, France
| | - Philippe Clavert
- Service de chirurgie du membre supérieur, Pôle de Chirurgie Orthopédique et de Traumatologie, hôpital de Hautepierre 2; CHU Strasbourg, 1, avenue Molière, 67200 Strasbourg, France
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Antoni M, Eichler D, Kempf JF, Clavert P. Anterior capsule re-attachment in terrible triad elbow injury with coronoid tip fracture. Orthop Traumatol Surg Res 2019; 105:1575-1583. [PMID: 31732394 DOI: 10.1016/j.otsr.2019.09.024] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2019] [Revised: 08/09/2019] [Accepted: 09/16/2019] [Indexed: 02/02/2023]
Abstract
BACKGROUND During the surgical treatment of terrible triad elbow injury (TTEI), the usefulness of re-attaching the anterior joint capsule when the coronoid tip is fractured remains unclear. The primary objective of this study was to assess potential benefits during surgery for TTEI of re-attaching the joint capsule when the coronoid tip is fractured. HYPOTHESIS Re-attaching the anterior joint capsule in TTEI with a fractured coronoid tip improves clinical and radiological outcomes and decreases the complication and revision rates. MATERIALS AND METHODS This single-centre retrospective study included patients who underwent surgery at the acute phase of TTEI with a fractured coronoid tip. In all patients, a physical examination and elbow radiographs were performed at least 1year after surgery. A statistical analysis was done to compare the groups with vs. without re-attachment of the anterior capsule and coronoid tip. RESULTS The study included 30 patients, 16 females and 14 males, with a mean age of 51years (range: 21-84years). Among them, 11 did and 19 did not undergo re-attachment. The two groups were comparable regarding demographic features and follow-up duration. No significant differences were found at last follow-up for flexion-extension motion arc (p=0.75), pronation-supination motion arc (p=0.3051), or the Mayo Elbow Performance Score (p=0.19). Radiographic evidence of humero-radial osteoarthritis was significantly more common in the absence of re-attachment (p=0.04), whereas no differences were evidenced regarding humero-ulnar osteoarthritis (p=0.73), the occurrence of subluxation or dislocation (p=0.43), or loosening of the radial head implant (p=0.47). The complication and revision rates were similar in the two groups. CONCLUSION In our experience, re-attaching the anterior capsule during the surgical treatment of TTEI with a coronoid tip fracture did not improve the clinical or radiographic outcomes after a mean follow-up of 54months. LEVEL OF EVIDENCE IV, retrospective study.
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Affiliation(s)
- Maxime Antoni
- Service de chirurgie du membre supérieur, hôpital de Hautepierre 2, CHU Strasbourg, 1, avenue Molière, 67098 Strasbourg cedex, France.
| | - David Eichler
- Service de chirurgie du membre supérieur, hôpital de Hautepierre 2, CHU Strasbourg, 1, avenue Molière, 67098 Strasbourg cedex, France
| | - Jean-François Kempf
- Service de chirurgie du membre supérieur, hôpital de Hautepierre 2, CHU Strasbourg, 1, avenue Molière, 67098 Strasbourg cedex, France
| | - Philippe Clavert
- Service de chirurgie du membre supérieur, hôpital de Hautepierre 2, CHU Strasbourg, 1, avenue Molière, 67098 Strasbourg cedex, France
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Antoni M, Schmucker A. The Research Data Centre of the German Federal Employment Agency at the Institute for Employment Research (RDC-IAB) - Linked Microdata for Labour Market Research. Int J Popul Data Sci 2019; 4:1141. [PMID: 32935042 PMCID: PMC7482517 DOI: 10.23889/ijpds.v4i2.1141] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022] Open
Abstract
Background and data portfolio Since 2004, the Research Data Centre of the German Federal Employment Agency at the Institute for Employment Research (RDC-IAB) has been offering comprehensive individual data on employees, unemployed persons, job seekers and participants in active labour market policy programmes for scientific labour market research. For this purpose, data from employer notifications and from different administrative processes in the labour market administration are linked. These administrative data are also combined with survey data. In addition, linked employer-employee data allow simultaneous analyses of the supply and demand sides of the labour market. Data linkage The data can be linked using unique identifiers, such as social insurance numbers, client numbers from local employment agencies, or establishment numbers. Since the foundation of the German Record Linkage Center (GRLC) in 2011, the RDC-IAB also applies methods for linking with non-unique and error-prone linkage identifiers like names, addresses and birth dates. Data access German data protection law classifies the data offered by the RDC-IAB as highly sensitive and strictly regulates their use by external researchers. The RDC-IAB has therefore established various data access modes. Although data can be transferred directly to research institutions in anonymised form, this procedure is generally not effective for linked data, as the loss of information due to the necessary anonymisation would be too great. For this reason, the RDC-IAB focuses on the access modes on-site use and remote data execution. In cooperation with other data centres, RDC-IAB has therefore established on-site data access at currently 16 locations worldwide.
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Affiliation(s)
- M Antoni
- Institute for Employment Research (IAB) of the German Federal Employment Agency (BA) Regensburger Strasse 104 D-90478 Nuremberg
| | - A Schmucker
- Institute for Employment Research (IAB) of the German Federal Employment Agency (BA) Regensburger Strasse 104 D-90478 Nuremberg
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Antoni M, Barthoulot M, Kempf JF, Clavert P. Revisions of total shoulder arthroplasty: Clinical results and complications of various modalities. Orthop Traumatol Surg Res 2016; 102:297-303. [PMID: 26969208 DOI: 10.1016/j.otsr.2016.01.009] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2015] [Revised: 10/10/2015] [Accepted: 01/05/2016] [Indexed: 02/02/2023]
Abstract
INTRODUCTION The number of primary total shoulder arthroplasties has increased exponentially in recent years, with a corresponding increase in the number of revision procedures. OBJECTIVE To assess clinical results and complications in a series of shoulder implant replacement, of whatever etiology. MATERIALS AND METHODS Thirty-seven patients, with a mean age of 68.3±11.8 years at time of implant replacement, were included in a retrospective study. Mean interval between primary arthroplasty and revision was 78.4±59.7 months (range, 1-200 months). The main assessment criterion was changed in Constant score between preoperative value and follow-up. Secondary criteria were: onset of intra- and postoperative complications, and reoperation related to a complication. RESULTS Mean follow-up was 41.5±32.0 months (range, 12-105 months). Absolute Constant score increased by a mean 17.5±15.1 points (P<0.001) and weighted Constant score by 26.3±23.6 points (P<0.001). Intraoperative complications occurred in 24.3% of patients (9/37) and postoperative complications in 29.7% (11/37). Among the patients, 21.6% (8/37) required reoperation for postoperative complications. Overall, 54% of patients (20/37) suffered from intra- or postoperative complications. CONCLUSION Shoulder implant replacement improved function in the present series, but with a high rate of complications and reoperations. LEVEL OF EVIDENCE IV, retrospective case-control study without control group.
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Affiliation(s)
- M Antoni
- Hôpitaux Universitaires de Strasbourg, Centre de Chirurgie Orthopédique de la Main, Service de Chirurgie Orthopédique et de Traumatologie, 10, avenue Achille-Baumann, 67400 Illkirch-Graffenstaden, France.
| | - M Barthoulot
- Hôpitaux Universitaires de Strasbourg, Laboratoire de Biostatistiques, Service de Santé Publique, 67000 Strasbourg, France
| | - J F Kempf
- Hôpitaux Universitaires de Strasbourg, Centre de Chirurgie Orthopédique de la Main, Service de Chirurgie Orthopédique et de Traumatologie, 10, avenue Achille-Baumann, 67400 Illkirch-Graffenstaden, France
| | - P Clavert
- Hôpitaux Universitaires de Strasbourg, Centre de Chirurgie Orthopédique de la Main, Service de Chirurgie Orthopédique et de Traumatologie, 10, avenue Achille-Baumann, 67400 Illkirch-Graffenstaden, France
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Schaefer S, Felix EM, Muench F, Antoni M, Lohaus C, Brötz J, Kunz U, Gärtner I, Ensinger W. NiCo nanotubes plated on Pd seeds as a designed magnetically recollectable catalyst with high noble metal utilisation. RSC Adv 2016. [DOI: 10.1039/c6ra10235b] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
The tailored structure of a bifunctional, semi-homogeneous NiCo-nanotube catalyst system with embedded Pd nanoparticles, is synthesised by electroless plating.
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Affiliation(s)
- S. Schaefer
- Technische Universität Darmstadt
- Department of Materials Science
- 64287 Darmstadt
- Germany
| | - E.-M. Felix
- Technische Universität Darmstadt
- Department of Materials Science
- 64287 Darmstadt
- Germany
| | - F. Muench
- Technische Universität Darmstadt
- Department of Materials Science
- 64287 Darmstadt
- Germany
| | - M. Antoni
- Technische Universität Darmstadt
- Department of Materials Science
- 64287 Darmstadt
- Germany
| | - C. Lohaus
- Technische Universität Darmstadt
- Department of Materials Science
- 64287 Darmstadt
- Germany
| | - J. Brötz
- Technische Universität Darmstadt
- Department of Materials Science
- 64287 Darmstadt
- Germany
| | - U. Kunz
- Technische Universität Darmstadt
- Department of Materials Science
- 64287 Darmstadt
- Germany
| | - I. Gärtner
- Technische Universität Darmstadt
- MPA/IfW Darmstadt
- 64283 Darmstadt
- Germany
| | - W. Ensinger
- Technische Universität Darmstadt
- Department of Materials Science
- 64287 Darmstadt
- Germany
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Antoni M, Rouillon I, Denoyelle F, Garabédian EN, Loundon N. Newborn hearing screening: Prevalence and medical and paramedical treatment of bilateral hearing loss in a neonatal series in the Île-de-France region of France. Eur Ann Otorhinolaryngol Head Neck Dis 2015; 133:95-9. [PMID: 26520479 DOI: 10.1016/j.anorl.2015.10.001] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
OBJECTIVES We report results for newborn hearing screening in a cohort of children born in the Île-de-France region of France, as part of a national screening program set up by the French national health insurance agency. MATERIALS AND METHODS A prospective study was performed on neonates undergoing hearing screening by automated auditory brainstem response at 35 dB in maternity departments between 2005 and 2011. In case of positive findings, a further check was performed; if this was also positive in one or both ears, the child was referred to the diagnostic center. RESULTS The study recruited 27,885 births; 96% of neonates were tested. Retest was positive in 0.84% of cases. Bilateral hearing loss was diagnosed in 0.63% of infants. Fifty-nine percent of these had ≥ 1 risk factor. Hearing normalized by end of follow-up in 25% of cases. Hearing loss was moderate in 59% of hearing-impaired children, severe in 12% and profound in 29%. Mean age at hearing aid fitting ranged from 4 months in profound hearing loss to 11.4 months in moderate hearing loss. In children receiving a cochlear implant, mean age at implantation was 14 months. CONCLUSION Newborn hearing screening is now public policy. It is effective in terms of exhaustiveness, age at diagnosis and early management. Caution is appropriate in the treatment of moderate hearing loss. In case of moderate hearing loss associated with otitis media serosa, transtympanic aerators should be suggested as of the age of 6 months to enable hearing threshold measurement. Hearing aid fitting can then be considered around 9 months of age if hearing has not improved.
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Affiliation(s)
- M Antoni
- Service d'ORL pédiatrique et de chirurgie cervico-faciale, hôpital Necker - Enfants-Malades, 149, rue de Sèvres, 75015 Paris, France
| | - I Rouillon
- Service d'ORL pédiatrique et de chirurgie cervico-faciale, hôpital Necker - Enfants-Malades, 149, rue de Sèvres, 75015 Paris, France.
| | - F Denoyelle
- Service d'ORL pédiatrique et de chirurgie cervico-faciale, hôpital Necker - Enfants-Malades, 149, rue de Sèvres, 75015 Paris, France
| | - E-N Garabédian
- Service d'ORL pédiatrique et de chirurgie cervico-faciale, hôpital Necker - Enfants-Malades, 149, rue de Sèvres, 75015 Paris, France
| | - N Loundon
- Service d'ORL pédiatrique et de chirurgie cervico-faciale, hôpital Necker - Enfants-Malades, 149, rue de Sèvres, 75015 Paris, France
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Antoni M, Jenny JY, Noll E. Postoperative pain control by intra-articular local anesthesia versus femoral nerve block following total knee arthroplasty: impact on discharge. Orthop Traumatol Surg Res 2014; 100:313-6. [PMID: 24703792 DOI: 10.1016/j.otsr.2013.12.022] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2013] [Revised: 11/08/2013] [Accepted: 12/16/2013] [Indexed: 02/02/2023]
Abstract
INTRODUCTION The goal of this retrospective study was to compare pain control following total knee arthroplasty (TKA) on a perioperative protocol of local anesthesia (LA) versus the more classical femoral nerve block (FNB) technique. HYPOTHESIS Fitness for discharge would be achieved earlier using the LA protocol. MATERIALS Ninety-eight consecutive TKA patients operated on by a single surgeon were included with no selection criteria. In the study group (49 patients), 200 mL ropivacaine 5% was injected into the surgical wound and an intra-articular catheter was fitted to provide continuous infusion of 20 mL/h ropivacaine for 24h. The control group (49 patients) received ropivacaine FNB. Discharge fitness (independent walking, knee flexion>90°, quadricipital control, pain on VAS≤3) and hospital stay were assessed. RESULTS Discharge fitness was achieved significantly earlier in the study group (4.2±2.6 versus 6.7±3.2 days; P=0.0003), with significantly shorter mean hospital stay (6.1±3.4 versus 8.8±3.5 days; P=0.0002). The complications rate did not differ between study and control groups. DISCUSSION Although retrospective, this study indicates that the LA protocol improves management of post-TKA pain and accelerates rehabilitation, thereby, reducing hospital stay. The acceleration effect may be due to the absence of quadriceps inhibition. LEVEL OF EVIDENCE Level III - Case control study.
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Affiliation(s)
- M Antoni
- Hôpitaux Universitaires de Strasbourg, Service de Chirurgie Orthopédique et Traumatologique, Centre de Chirurgie Orthopédique et de la Main, 10, avenue Bauymann, 67400 Illkirch-Graffenstaden, France
| | - J-Y Jenny
- Hôpitaux Universitaires de Strasbourg, Service de Chirurgie Orthopédique et Traumatologique, Centre de Chirurgie Orthopédique et de la Main, 10, avenue Bauymann, 67400 Illkirch-Graffenstaden, France.
| | - E Noll
- Hôpitaux Universitaires de Strasbourg, Service d'Anesthésie-Réanimation, Centre de Chirurgie Orthopédique et de la Main, 10, avenue Bauymann, 67400 Illkirch-Graffenstaden, France
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Schmitt M, Limage S, Grigoriev DO, Krägel J, Dutschk V, Vincent-Bonnieu S, Miller R, Antoni M. Transition from spherical to irregular dispersed phase in water/oil emulsions. Langmuir 2014; 30:4599-4604. [PMID: 24593776 DOI: 10.1021/la404766w] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Bulk properties of transparent and dilute water in paraffin oil emulsions stabilized with sodium dodecyl sulfate (SDS) are analyzed by optical scanning tomography. Each scanning shot of the considered emulsions has a precision of 1 μm. The influence of aluminum oxide nanoparticles in the structure of the water droplets is investigated. Depending on concentrations of SDS and nanoparticles, a transition occurs in their shape that changes from spherical to polymorphous. This transition is controlled by the SDS/alumina nanoparticles mixing ratio and is described using an identification procedure of the topology of the gray level contours extracted from each images. The transition occurs for a critical mixing ratio of Rcrit ≈ 0.05 which does not significantly depend on temperature and electrolyte concentration. This structural change seems to be a general feature when emulsifying dispersions and most probably involves both interfacial and bulk phenomena.
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Affiliation(s)
- M Schmitt
- Aix-Marseille Université , CNRS, MADIREL UMR 7246, 13397 Marseille cedex 20, France
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Ronde-Oustau C, Diesinger Y, Jenny JY, Antoni M, Gaudias J, Boeri C, Sibilia J, Lessinger JM. Diagnostic accuracy of intra-articular C-reactive protein assay in periprosthetic knee joint infection--a preliminary study. Orthop Traumatol Surg Res 2014; 100:217-20. [PMID: 24582652 DOI: 10.1016/j.otsr.2013.10.017] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2013] [Revised: 09/12/2013] [Accepted: 10/03/2013] [Indexed: 02/02/2023]
Abstract
BACKGROUND Periprosthetic joint infection often raises diagnostic challenges, as the published criteria are heterogeneous. New markers for predicting periprosthetic infection have been evaluated. Here, we assessed one of these markers, C-reactive protein (CRP), in joint fluid. HYPOTHESIS We hypothesised that intra-articular CRP levels would perform better than serum CRP concentrations in diagnosing knee prosthesis infection. PATIENTS AND METHODS We prospectively included 30 patients including 10 with native-knee effusions, 11 with prosthetic-knee aseptic effusions, and 11 with prosthetic-knee infection defined using 2011 Musculoskeletal Society criteria. Serum CRP was assayed using turbidimetry or nephelometry and intra-articular CRP using nephelometry. Appropriate statistical tests were performed to compare the three groups; P values < 0.05 were considered significant. RESULTS Serum and intra-articular CRP levels were 5- to 16-fold higher in the group with periprosthetic infection than in the other two groups. Although the areas under the ROC curves were not significantly different, the likelihood ratios associated with the selected cut-offs suggested superiority of intra-articular CRP: a value > 2.78 mg/L suggested possible infection (100% sensitivity and 82% specificity) and a value > 5.37 mg/L probable infection (90% sensitivity and 91% specificity). DISCUSSION Our findings suggest a possible role for intra-articular CRP assay in diagnosing knee prosthesis infection and perhaps periprosthetic infection at any site. LEVEL OF EVIDENCE Level III, diagnostic study, development of a diagnostic criterion in consecutive patients comparatively to a reference standard.
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Affiliation(s)
- C Ronde-Oustau
- Service de rhumatologie, Hôpitaux Universitaires de Strasbourg, avenue Molière, 67200 Strasbourg, France
| | - Y Diesinger
- Centre de chirurgie orthopédique et de la main, Hôpitaux Universitaires de Strasbourg, 10, avenue Baumann, 67400 Illkirch, France
| | - J-Y Jenny
- Centre de chirurgie orthopédique et de la main, Hôpitaux Universitaires de Strasbourg, 10, avenue Baumann, 67400 Illkirch, France.
| | - M Antoni
- Centre de chirurgie orthopédique et de la main, Hôpitaux Universitaires de Strasbourg, 10, avenue Baumann, 67400 Illkirch, France
| | - J Gaudias
- Centre de chirurgie orthopédique et de la main, Hôpitaux Universitaires de Strasbourg, 10, avenue Baumann, 67400 Illkirch, France
| | - C Boeri
- Centre de chirurgie orthopédique et de la main, Hôpitaux Universitaires de Strasbourg, 10, avenue Baumann, 67400 Illkirch, France
| | - J Sibilia
- Service de rhumatologie, Hôpitaux Universitaires de Strasbourg, avenue Molière, 67200 Strasbourg, France
| | - J-M Lessinger
- Laboratoire de biochimie et biologie moléculaire, Hôpitaux Universitaires de Strasbourg, 1, place de l'Hôpital, 67000 Strasbourg, France
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Ronde-Oustau C, Antoni M, Gaudias J, Boeri C, Sibilia J, Jenny JY. AB0646 Intra-articular level of c-reactive protein in diagnosis of prosthetic knee infection. Ann Rheum Dis 2013. [DOI: 10.1136/annrheumdis-2013-eular.2968] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Jean-Pierre P, Winters P, Ahles T, Antoni M, Armstrong D, Penedo F, Lipshultz SE, Miller TL, Fiscella K. Cancer-related memory problems, demographic, and socioeconomic backgrounds: A cross-sectional study of the United States population. J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.15_suppl.9084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Limage S, Schmitt M, Vincent-Bonnieu S, Dominici C, Antoni M. Characterization of solid-stabilized water/oil emulsions by scanning electron microscopy. Colloids Surf A Physicochem Eng Asp 2010. [DOI: 10.1016/j.colsurfa.2010.02.037] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Jones DL, Ishii M, LaPerriere A, Stanley H, Antoni M, Ironson G, Schneiderman N, Van Splunteren F, Cassells A, Alexander K, Gousse YP, Vaughn A, Brondolo E, Tobin JN, Weiss SM. Influencing medication adherence among women with AIDS. AIDS Care 2010; 15:463-74. [PMID: 14509861 DOI: 10.1080/0954012031000134700] [Citation(s) in RCA: 48] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
This study examined the effects of a ten-session cognitive-behavioural stress management/expressive supportive therapy (CBSM+) intervention on adherence to antiretroviral medication. Although the intervention was not designed to influence adherence, it was theorized that improved coping and social support could enhance adherence. Women with AIDS (N = 174) in Miami, New York and New Jersey, USA, were randomized to a group CBSM+ intervention or individual control condition. Participants were African American (55%), Latina (18%) and Caribbean (18%) with drug (55%) and/or alcohol (32%) histories. Participants were assessed on self-reported medication adherence over seven days, HIV-related coping strategies and beliefs regarding HIV medication. Baseline overall self-reported adherence rates were moderate and related to coping strategies and HIV medication beliefs. Low adherent (80%) participants in the intervention condition increased their mean self-reported medication adherence (30.4% increase, t44 = 3.1, p < 0.01), whereas low adherent women in the control condition showed a non-significant trend (19.6% increase, t44 = 2.0, p > 0.05). The intervention did not improve adherence in this population; conditions did not differ significantly on self-reported adherence. Low adhering intervention participants significantly decreased levels of denial-based coping (F1,88 = 5.97, p < 0.05). Results suggest that future interventions should utilize group formats and address adherence using coping and medication-knowledge focused strategies.
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Affiliation(s)
- D L Jones
- Department of Psychology, Barry University, 11300 NE 2nd Avenue, Miami Shores, Florida 33161-6695, USA.
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Jean-Pierre P, Winters P, Ahles T, Antoni M, Armstrong D, Penedo F, Lipshultz SE, Miller TL, Morrow GR, Fiscella K. Prevalence of memory problems that limit daily functioning in adult cancer patients: A national representative sample of the U.S. population. J Clin Oncol 2010. [DOI: 10.1200/jco.2010.28.15_suppl.9134] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Schmitt-Rozières M, Krägel J, Grigoriev DO, Liggieri L, Miller R, Vincent-Bonnieu S, Antoni M. From spherical to polymorphous dispersed phase transition in water/oil emulsions. Langmuir 2009; 25:4266-4270. [PMID: 19281158 DOI: 10.1021/la804214m] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
Optical scanning tomography is used to characterize bulk properties of transparent water-in-paraffin oil emulsions stabilized with hexadecyl-trimethylammonium bromide (CTAB) and silica nanoparticles. A flow of 500 hundred images is used to analyze each scanning shot with a precision of about 1 microm. The role of silica particles in the shape of the water droplets is investigated. Depending on the concentration of CTAB and silica nanoparticles, a transition occurs in their geometry that changes from spherical to polymorphous. This transition is controlled by the ratio R=[CTAB]/[SiO2] and is described using an identification procedure of the topology of the gray level contours of the tomographic images. The transition occurs for Rcrit approximately 3x10(-2) and is shown to correspond to a pH of the dispersed phase of 8.5.
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Affiliation(s)
- M Schmitt-Rozières
- Aix-Marseille Université-Université Paul Cézanne UMR-CNRS 6263 ISM2, Centre St. Jérôme, BP. 451, Marseille 13397 Marseille, Cedex 20, France
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Abstract
In this letter we show that the Marangoni flow contribution to the evaporation rate of small heated water droplets resting on hot substrates is negligible. We compare data of evaporating droplet experiments with numerical results and assess the effect of Marangoni flow and its contribution to the evaporation process. We demonstrate that heat conduction inside these water droplets is sufficient to give an accurate estimate of evaporation rates. Although convection in evaporating water droplets remains an open problem, our aim in this study is to demonstrate that these effects can be neglected in the investigation of evaporation rate evaluation. It is worth noting that the presented results apply to volatile heated drops which might differ from spontaneously evaporating cases.
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Affiliation(s)
- F Girard
- School of Engineering and Electronics, University of Edinburgh, Kings Buildings, Edinburgh, EH9 3JL, United Kingdom
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Antoni M, Krägel J, Liggieri L, Miller R, Sanfeld A, Sylvain J. Binary emulsion investigation by optical tomographic microscopy for FASES experiments. Colloids Surf A Physicochem Eng Asp 2007. [DOI: 10.1016/j.colsurfa.2007.02.043] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Ironson G, Friedman A, Klimas N, Antoni M, Fletcher MA, Laperriere A, Simoneau J, Schneiderman N. Distress, denial, and low adherence to behavioral interventions predict faster disease progression in gay men infected with human immunodeficiency virus. Int J Behav Med 2006; 1:90-105. [PMID: 16250807 DOI: 10.1207/s15327558ijbm0101_6] [Citation(s) in RCA: 114] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
This study examined psychological prediction of 2-year disease progression in gay men after finding out their human immunodeficiency virus (HIV) serostatus. Psychological and immune status of asymptomatic gay men who did not know their HIV serostatus was monitored during the 5 weeks before and after serostatus notification. The men were randomly assigned to an exercise. cognitive-behavioral stress-management intervention, or control group. At 2-year follow-up for the 23 men who turned out to be seropositive. 9 had developed symptoms, including 5 with acquired immune deficiency syndrome--4 of whom died. Distress at diagnosis, denial (5 weeks post-diagnosis minus pre-diagnosis). and low adherence during interventions were significant predictors of 2-year disease progression. Denial and adherence remained significant predictors of disease progression even after controlling for CD4 number at entry. Furthermore. change in denial was significantly correlated with immune status 1 year later; l-year immune status was significantly correlated with 2-year disease progression. The present study therefore demonstrates significant relations between psychological variables on the one hand and both immune measures and HIV-1 disease progression on the other. We conclude that distress, denial, and low protocol compliance predict subsequent disease progression.
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Affiliation(s)
- G Ironson
- Department of Psychology, University of Miami, FL, USA
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Ironson G, Weiss S, Lydston D, Ishii M, Jones D, Asthana D, Tobin J, Lechner S, Laperriere A, Schneiderman N, Antoni M. The impact of improved self-efficacy on HIV viral load and distress in culturally diverse women living with AIDS: the SMART/EST Women's Project. AIDS Care 2005; 17:222-36. [PMID: 15763716 DOI: 10.1080/09540120512331326365] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
The purpose of the present study was to determine whether changes in self-efficacy over time would be related to changes in disease progression markers (CD4, viral load) in a sample of women with AIDS. A self-efficacy measure was developed and two sub-scales emerged via factor analysis of 391 HIV-positive women: AIDS Self-efficacy and Cognitive Behavioral Skills Self-efficacy. Subsequently, the sub-scales and an additional adherence self-efficacy item were given to 56 HIV-positive women who were measured at two time points three months apart. Half of these women were randomly assigned to a CB intervention and half to a low intensity comparison condition. Increases in AIDS Self-efficacy over the three-month period were significantly related to increases in CD4 and decreases in viral load. Similarly, increases in Cognitive Behavioral Skills Self-efficacy were significantly related to decreases in distress over time. Findings were maintained within the intervention group alone. Interestingly, increases in cognitive behavioral skills self-efficacy and increases in the self-efficacy adherence item were also significantly related to decreases in viral load. Implications of the findings and suggestions for future research are discussed.
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Affiliation(s)
- G Ironson
- Department of Psychology, University of Miami, PO Box 248185, Coral Gables, FL 33146, USA.
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Affiliation(s)
- V. Cuny
- Université Paul-Cézanne - Aix-Marseille III, UMR-CNRS 6178 Symbio - Chimie informatique et modélisation moléculaire and UMR-CNRS 6171 Systèmes Chimiques Complexes-Thermodynamique et modélisation des milieux hors équilibre, BP 531, Av. Escadrille Normandie-Niemen, 13397 Marseille Cedex 20, France, and CNR-ICFAM, Via de Marini 6, 16149 Genova, Italy
| | - M. Antoni
- Université Paul-Cézanne - Aix-Marseille III, UMR-CNRS 6178 Symbio - Chimie informatique et modélisation moléculaire and UMR-CNRS 6171 Systèmes Chimiques Complexes-Thermodynamique et modélisation des milieux hors équilibre, BP 531, Av. Escadrille Normandie-Niemen, 13397 Marseille Cedex 20, France, and CNR-ICFAM, Via de Marini 6, 16149 Genova, Italy
| | - M. Arbelot
- Université Paul-Cézanne - Aix-Marseille III, UMR-CNRS 6178 Symbio - Chimie informatique et modélisation moléculaire and UMR-CNRS 6171 Systèmes Chimiques Complexes-Thermodynamique et modélisation des milieux hors équilibre, BP 531, Av. Escadrille Normandie-Niemen, 13397 Marseille Cedex 20, France, and CNR-ICFAM, Via de Marini 6, 16149 Genova, Italy
| | - L. Liggieri
- Université Paul-Cézanne - Aix-Marseille III, UMR-CNRS 6178 Symbio - Chimie informatique et modélisation moléculaire and UMR-CNRS 6171 Systèmes Chimiques Complexes-Thermodynamique et modélisation des milieux hors équilibre, BP 531, Av. Escadrille Normandie-Niemen, 13397 Marseille Cedex 20, France, and CNR-ICFAM, Via de Marini 6, 16149 Genova, Italy
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Antoni M, Ruffo S, Torcini A. First- and second-order clustering transitions for a system with infinite-range attractive interaction. Phys Rev E Stat Nonlin Soft Matter Phys 2002; 66:025103. [PMID: 12241224 DOI: 10.1103/physreve.66.025103] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/26/2002] [Indexed: 05/23/2023]
Abstract
We consider a Hamiltonian system made of N classical particles moving in two dimensions, coupled via an infinite-range interaction gauged by a parameter A. This system shows a low energy phase with most of the particles trapped in a unique cluster. At higher energy it exhibits a transition towards a homogenous phase. For sufficiently strong coupling A, an intermediate phase characterized by two clusters appears. Depending on the value of A, the observed transitions can be either second or first order in the canonical ensemble. In the latter case, microcanonical results differ dramatically from canonical ones. However, a canonical analysis, extended to metastable and unstable states, is able to describe the microcanonical equilibrium phase. In particular, a microcanonical negative specific heat regime is observed in the proximity of the transition whenever it is canonically discontinuous. In this regime, microcanonically stable states are shown to correspond to saddles of the Helmholtz free energy, located inside the spinodal region.
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Affiliation(s)
- M Antoni
- UMR-CNRS 6171, Université d'Aix-Marseille III, Avenue de l'Escadrille Normandie-Niemen, 13397 Marseille Cedex 20, France
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Patarca-Montero R, Antoni M, Fletcher MA, Klimas NG. Cytokine and other immunologic markers in chronic fatigue syndrome and their relation to neuropsychological factors. Appl Neuropsychol 2001; 8:51-64. [PMID: 11388124 DOI: 10.1207/s15324826an0801_7] [Citation(s) in RCA: 63] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
The literature is reviewed and data are presented that relate to a model we have developed to account for the perpetuation of the perplexing disorder currently termed chronic fatigue syndrome (CFS). In patients with CFS there is chronic lymphocyte overactivation with cytokine abnormalities that include perturbations in plasma levels of proinflammatory cytokines and decrease in the ratio of Type 1 to Type 2 cytokines produced by lymphocytes in vitro following mitogen stimulation. The initiation of the syndrome is frequently sudden and often follows an acute viral illness. Our model for the subsequent chronicity of this disorder holds that the interaction of psychological factors (distress associated with either CFS-related symptoms or other stressful life events) and the immunologic dysfunction contribute to (a) CFS-related physical symptoms (e.g., perception of fatigue and cognitive difficulties, fever, muscle and joint pain) and increases in illness burden and (b) impaired immune surveillance associated with cytotoxic lymphocytes with resulting activation of latent herpes viruses.
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Affiliation(s)
- R Patarca-Montero
- E. M. Papper Laboratory of Clinical Immunology, Center for Behavioral Medicine Research, Miami Veterans Administration Medical Center, University of Miami School of Medicine, P.O. Box 016960, Miami, FL 33101, USA
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Cruess S, Antoni M, Cruess D, Fletcher MA, Ironson G, Kumar M, Lutgendorf S, Hayes A, Klimas N, Schneiderman N. Reductions in herpes simplex virus type 2 antibody titers after cognitive behavioral stress management and relationships with neuroendocrine function, relaxation skills, and social support in HIV-positive men. Psychosom Med 2000; 62:828-37. [PMID: 11139003 DOI: 10.1097/00006842-200011000-00013] [Citation(s) in RCA: 79] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
OBJECTIVE Coinfection with herpes simplex virus type 2 (HSV-2) is common in individuals infected with human immunodeficiency virus (HIV) and may have health implications. This study examined the effect of a 10-week cognitive behavioral stress management (CBSM) intervention on immunoglobulin G (IgG) antibody titers to HSV-2 in a group of mildly symptomatic HIV-infected gay men and the degree to which these effects were mediated by psychosocial and endocrine changes during the 10-week period. METHODS Sixty-two HIV+ gay men were randomly assigned to either a 10-week CBSM intervention (N = 41) or a wait-list control condition (N = 21). Anxious mood, social support, cortisol/dehydroepiandrosterone sulfate (DHEA-S) ratio levels, and HSV-2 IgG antibody titers were assessed at baseline and after the 10-week period. CBSM participants also recorded their stress levels before and after at-home relaxation practice. RESULTS HSV-2 IgG titers were significantly reduced in the CBSM participants but remained unchanged in the control group after the 10-week intervention period. Increases in one type of social support, perceived receipt of guidance, during the 10 weeks was associated with and partially mediated the effect of the intervention on HSV-2 IgG. Similarly, decreases in cortisol/DHEA-S ratio levels were associated with decreases in HSV-2 IgG, and lower mean stress levels achieved after home relaxation practice were associated with greater decreases in HSV-2 IgG among CBSM participants. CONCLUSIONS These findings suggest that behavioral and psychosocial changes occurring during CBSM interventions, including relaxation, enhanced social support, and adrenal hormone reductions, may help to explain the effects of this form of stress management on immune indices such as HSV-2 antibody titers.
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Affiliation(s)
- S Cruess
- Department of Psychology, University of Miami, FL, USA
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Ouzan D, Desmorat H, Bourlière M, Baldini E, Boyer N, Fontanges T, Mathieu-Chandelier C, Jacques JP, Baesjou S, Rouhier D, Louvet H, Hanslik B, Beorchia S, Antoni M, Brunerie M, Corcos D, Richard-Molard B, Pierrugues R, Caucanas J, Jouanolle H, Khiri ZAH, Brichetti A, Halfon P. Étude multicentrique contrôlée de traitement par Pinterféron α2b de l'hépatite chronique C. L'administration d'une dose d'attaque (5 MU) 6 mois puis d'entretien (3 MU) 6 mois augmente-t-elle le taux de réponse durable ? Rev Med Interne 1997. [DOI: 10.1016/s0248-8663(97)80294-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Ironson G, Wynings C, Schneiderman N, Baum A, Rodriguez M, Greenwood D, Benight C, Antoni M, LaPerriere A, Huang HS, Klimas N, Fletcher MA. Posttraumatic stress symptoms, intrusive thoughts, loss, and immune function after Hurricane Andrew. Psychosom Med 1997; 59:128-41. [PMID: 9088048 DOI: 10.1097/00006842-199703000-00003] [Citation(s) in RCA: 287] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
OBJECTIVE To examine the impact of and relationship between exposure to Hurricane Andrew, a severe stressor, posttraumatic stress symptoms and immune measures. METHODS Blood draws and questionnaires were taken from community volunteer subjects living in the damaged neighborhoods between 1 and 4 months after the Hurricane. RESULTS The sample exhibited high levels of posttraumatic stress symptoms by questionnaire (33% overall; 76% with at least one symptom cluster), and 44% scored in the high impact range on the Impact of Events (IES) scale. A substantial proportion of variance in posttraumatic stress symptoms could be accounted for by four hurricane experience variables (damage, loss, life threat, and injury), with perceived loss being the highest correlate. Of the five immune measures studied Natural Killer Cell Cytotoxicity (NKCC) was the only measure that was meaningfully related (negatively) to both damage and psychological variables (loss, intrusive thoughts, and posttraumatic stress disorder (PTSD). White blood cell counts (WBCs) were significantly positively related with the degree of loss and PTSD experienced. Both NKCC (lower) and WBC were significantly related to retrospective self-reported increase of somatic symptoms after the hurricane. Overall, the community sample was significantly lower in NKCC, CD4 and CD8 number, and higher in NK cell number compared to laboratory controls. Finally, evidence was found for new onset of sleep problems as a mediator of the posttraumatic symptom-NKCC relationship. CONCLUSIONS Several immune measures differed from controls after Hurricane Andrew. Negative (intrusive) thoughts and PTSD were related to lower NKCC. Loss was a key correlate of both posttraumatic symptoms and immune (NKCC, WBC) measures.
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Affiliation(s)
- G Ironson
- Department of Psychology, University of Miami, Coral Gables, Florida 33124, USA
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Galardi G, Perani D, Grassi F, Bressi S, Amadio S, Antoni M, Comi GC, Canal N, Fazio F. Basal ganglia and thalamo-cortical hypermetabolism in patients with spasmodic torticollis. Acta Neurol Scand 1996; 94:172-6. [PMID: 8899050 DOI: 10.1111/j.1600-0404.1996.tb07049.x] [Citation(s) in RCA: 74] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
UNLABELLED The basal ganglia are thought to be involved in the primary dystonias, largely because of the repeated demonstration of neuropathological changes in these nuclei in the secondary dystonias. A hyperactivity of a network involving basal ganglia has been suggested in experimental animal dystonia. To test this hypothesis in humans, we studied the functional correlates of primary cervical dystonia using [18F]FDG and PET. MATERIAL AND METHODS Regional cerebral glucose metabolism (rCMRglc) was measured in 10 patients with idiopathic torticollis (6 drug-free and 4 drug-naive) and in 15 normal controls, using 2-[18F]-fluoro-2-deoxy-D-glucose ([18F]FDG) and positron emission tomography (PET). RESULTS A significant hypermetabolism in the basal ganglia, thalamus, premotor-motor cortex and cerebellum in the patients compared with normal controls was found. The patients were correctly assigned to their clinical category by a discriminant function analysis with a total accuracy of 96%. CONCLUSION The results support the hypothesis that a dysfunction of a subcortical-cortical motor network may play a role in the pathogenesis of focal dystonia, in agreement with the experimental dystonia models.
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Affiliation(s)
- G Galardi
- Scientific Institute H San Raffaele, Milan, Italy
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van der Pompe G, Antoni M, Visser A, Garssen B. Adjustment to breast cancer: the psychobiological effects of psychosocial interventions. Patient Educ Couns 1996; 28:209-219. [PMID: 8852096 DOI: 10.1016/0738-3991(96)00895-6] [Citation(s) in RCA: 22] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
Abstract
This review focuses on the effects of psychosocial interventions on psychological and biological functioning of breast cancer patients. Once in their lifetime, one out of eleven women receive a diagnosis of breast cancer. A diagnosis of breast cancer is a severe stressful life event with profound consequences on all aspects of human life. Whether a woman will regain emotional balance and accept the idea of living with a potentially life threatening disease depends on her psychological resiliency. Provision of psychosocial interventions can improve these women's coping abilities and reduce emotional distress and feelings of isolation, and improve psychosexual functioning. Additionally, there exists some evidence that psychotherapy may prolong survival. Prolongation of survival may be related, in part, to an increase in certain aspects of immune function (e.g., natural killer cell activity). This is plausible because the function of the immune system seems to be related to mammary tumor growth. Therefore, future research should examine the degree to which the effects on mammary tumor growth relate to immune system changes.
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Antoni M, Ruffo S. Clustering and relaxation in Hamiltonian long-range dynamics. Phys Rev E Stat Phys Plasmas Fluids Relat Interdiscip Topics 1995; 52:2361-2374. [PMID: 9963678 DOI: 10.1103/physreve.52.2361] [Citation(s) in RCA: 172] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
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Visser A, Antoni M. Current perspectives on AIDS/HIV education and counseling. Patient Educ Couns 1994; 24:191-198. [PMID: 7753714 DOI: 10.1016/0738-3991(94)90064-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
Abstract
This whole issue of Patient Education and Counseling is devoted to current perspectives on AIDS/HIV education and counseling. The results of 15 completed empirical studies and empirically-based reviews are described, highlighting the central role of education and counseling in research and clinical practice in the AIDS/HIV arena in the USA, UK, Australia, The Netherlands, and Israel. The articles concern: readability of educational materials, format of informed consent, participation of drug users in HIV-testing, measurement of condom use, safe sex among the young and non-monogamous, sexual network analysis, high-risk sexual behavior among gay men, prostitution, public reactions towards people with AIDS, teachers' attitudes towards AIDS, measurement of mental adjustment to AIDS, influencing quality of life by counseling, satisfaction with HIV counseling, the influence of psychosocial factors on the course of HIV infection, and a report on the recently held 10th International Conference on AIDS.
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