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Battistin T, Mercuriali E, Borghini C, Reffo ME, Suppiej A. Parental Satisfaction with the Quality of Care in an Early Intervention Service for Children with Visual Impairment: A Retrospective Longitudinal Study. Children (Basel) 2024; 11:230. [PMID: 38397342 PMCID: PMC10887141 DOI: 10.3390/children11020230] [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: 12/22/2023] [Revised: 02/07/2024] [Accepted: 02/08/2024] [Indexed: 02/25/2024]
Abstract
The fundamental role of vision during development and the nurturing role of early intersubjectivity have enabled the Robert Hollman Foundation to develop an early intervention program providing holistic support to visually impaired children and their families, where fostering parent-infant interactions is at the heart of our care. The aim of this study is to understand how parents perceive this approach. It is an eleven-year retrospective study of children following the Robert Hollman Foundation's early intervention program, in which parents' (n = 1086) perceptions of quality of care were measured through the administration of a specifically designed 4-point scale questionnaire. Annual longitudinal trends of parents' perceptions were calculated for every single response. Parents reported a very high satisfaction value in 21/23 questions (Mean > 3.7 out of a maximum score of 4, with the highest scores in human and soft skills of professionals) with a statistically positive trend (p < 0.05), throughout the period considered. Our core approach, based on an individualized nurturing relational support, has been appreciated and confirmed by the high satisfaction reported in the questionnaires by parents of children with visual impairment. We therefore hypothesize that parent-infant relationship-based and individualized approaches may help parents achieve better health, well-being, and quality of daily life for their children.
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Affiliation(s)
- Tiziana Battistin
- Department of Neurosciences and Rehabilitation, University of Ferrara, 44121 Ferrara, Italy
- Robert Hollman Foundation, 35143 Padova, Italy; (E.M.); (M.E.R.); (A.S.)
- Robert Hollman Foundation, 28821 Cannero Riviera, Italy
| | - Elena Mercuriali
- Robert Hollman Foundation, 35143 Padova, Italy; (E.M.); (M.E.R.); (A.S.)
- Robert Hollman Foundation, 28821 Cannero Riviera, Italy
| | - Carlotta Borghini
- Unit of Biostatistics, Epidemiology and Public Health, Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padua, 35131 Padua, Italy;
| | - Maria Eleonora Reffo
- Robert Hollman Foundation, 35143 Padova, Italy; (E.M.); (M.E.R.); (A.S.)
- Robert Hollman Foundation, 28821 Cannero Riviera, Italy
| | - Agnese Suppiej
- Robert Hollman Foundation, 35143 Padova, Italy; (E.M.); (M.E.R.); (A.S.)
- Robert Hollman Foundation, 28821 Cannero Riviera, Italy
- Department of Medical Sciences, University of Ferrara, 44121 Ferrara, Italy
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Kim SY, Na HS, Park JI, Lee KO, Shin HJ. Comparison of the Effect of Landmark-Based Midline and Paramedian Approaches on Spinal Anesthesia-Related Complications in Adult Patients: A Meta-Analysis of Randomized Controlled Trials. Medicina (Kaunas) 2024; 60:178. [PMID: 38276057 PMCID: PMC10819311 DOI: 10.3390/medicina60010178] [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: 12/21/2023] [Revised: 01/05/2024] [Accepted: 01/18/2024] [Indexed: 01/27/2024]
Abstract
Background and Objectives: Spinal anesthesia is widely used in various types of surgery. However, several complications can occur afterward. This study aimed to identify differences in the incidence of anesthesia-related complications according to the approach methods (midline versus paramedian) for landmark-based spinal anesthesia. Materials and Methods: We searched electronic databases, including PubMed, EMBASE, CENTRAL, Scopus, and Web of Science, for eligible randomized controlled trials. The primary outcome was post-dural puncture headache (PDPH) incidence, and secondary outcomes were low back pain (LBP) incidence and success rate in the first trial of spinal anesthesia. We estimated the odds ratio (OR) with 95% confidence intervals (CI) using a random-effects model. Results: In total, 2280 patients from 13 randomized controlled trials were included in the final analysis. The incidence rates of PDPH were 5.9% and 10.4% in the paramedian and midline approach groups, respectively. The pooled effect size revealed that the incidence of PDPH (OR: 0.43, 95% CI [0.22-0.83]; p = 0.01; I2 = 53%) and LBP (OR: 0.27, 95% CI [0.16-0.44]; p < 0.001; I2 = 16%) decreased, and the success rate in the first attempt was higher (OR: 2.30, 95% CI [1.36-3.87]; p = 0.002; I2 = 35%) with the paramedian than with the midline approach. Conclusions: Paramedian spinal anesthesia reduced PDPH and LBP and increased the success rate of the first attempt.
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Affiliation(s)
- Su Yeon Kim
- Department of Anesthesiology and Pain Medicine, Seoul National University Bundang Hospital, Seongnam 13620, Republic of Korea; (S.Y.K.); (H.-S.N.); (J.I.P.); (K.-O.L.)
| | - Hyo-Seok Na
- Department of Anesthesiology and Pain Medicine, Seoul National University Bundang Hospital, Seongnam 13620, Republic of Korea; (S.Y.K.); (H.-S.N.); (J.I.P.); (K.-O.L.)
- Department of Anesthesiology and Pain Medicine, Seoul National University College of Medicine, Seoul 03080, Republic of Korea
| | - Ji In Park
- Department of Anesthesiology and Pain Medicine, Seoul National University Bundang Hospital, Seongnam 13620, Republic of Korea; (S.Y.K.); (H.-S.N.); (J.I.P.); (K.-O.L.)
| | - Keum-O Lee
- Department of Anesthesiology and Pain Medicine, Seoul National University Bundang Hospital, Seongnam 13620, Republic of Korea; (S.Y.K.); (H.-S.N.); (J.I.P.); (K.-O.L.)
| | - Hyun-Jung Shin
- Department of Anesthesiology and Pain Medicine, Seoul National University Bundang Hospital, Seongnam 13620, Republic of Korea; (S.Y.K.); (H.-S.N.); (J.I.P.); (K.-O.L.)
- Department of Anesthesiology and Pain Medicine, Seoul National University College of Medicine, Seoul 03080, Republic of Korea
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Braganholo RC, Bánkuti FI, Dos Santos FS, Pedrosa VB, Zambom MA, Valloto AA, Dos Santos GT. Age at first calving and productive performance of primiparous Holsteins. J DAIRY RES 2023; 90:353-356. [PMID: 38420730 DOI: 10.1017/s0022029923000729] [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] [Subscribe] [Scholar Register] [Indexed: 03/02/2024]
Abstract
This study investigated the age at first calving in Holstein heifers and its impact on various production parameters. A sample of 737 Holstein heifers born between 2015 and 2018 and finishing their first lactations between 2018 and 2020 was included. Cluster analysis revealed three groups based on age at first calving: high precocity, medium precocity and low precocity. Medium-precocity group exhibited the highest 305-day milk yield and peak milk production. Additionally, the same group demonstrated superior mean production per lactation, 305-day milk protein content, and 305-day milk yield. The lowest somatic cell count was found in the low-precocity group. In conclusion, medium-precocity cows showed better results such as higher 305-day milk yield and peak milk production.
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Affiliation(s)
- Rafael Ceolim Braganholo
- Postgraduate Program in Animal Science, State University of Maringá (UEM), Maringá, Paraná (PR), 87020-900, Brazil
| | - Ferenc Istvan Bánkuti
- Postgraduate Program in Animal Science, State University of Maringá (UEM), Maringá, Paraná (PR), 87020-900, Brazil
| | - Fabio Seiji Dos Santos
- Postgraduate Program in Animal Science, Western PR State University (UNIOESTE), Marechal Cândido Rondon, Paraná, 85960-000, Brazil
| | - Victor Breno Pedrosa
- Postgraduate Program in Animal Science, State University of Ponta Grossa, Ponta Grossa, PR, 84010-340, Brazil
| | - Maximiliane Alavarse Zambom
- Postgraduate Program in Animal Science, Western PR State University (UNIOESTE), Marechal Cândido Rondon, Paraná, 85960-000, Brazil
| | | | - Geraldo Tadeu Dos Santos
- Postgraduate Program in Animal Science, State University of Maringá (UEM), Maringá, Paraná (PR), 87020-900, Brazil
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Alabdaljabar MS, Hasan B, Noseworthy PA, Maalouf JF, Ammash NM, Hashmi SK. Machine Learning in Cardiology: A Potential Real-World Solution in Low- and Middle-Income Countries. J Multidiscip Healthc 2023; 16:285-295. [PMID: 36741292 PMCID: PMC9891080 DOI: 10.2147/jmdh.s383810] [Citation(s) in RCA: 2] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Accepted: 11/07/2022] [Indexed: 01/30/2023] Open
Abstract
Artificial intelligence (AI) and machine learning (ML) is a promising field of cardiovascular medicine. Many AI tools have been shown to be efficacious with a high level of accuracy. Yet, their use in real life is not well established. In the era of health technology and data science, it is crucial to consider how these tools could improve healthcare delivery. This is particularly important in countries with limited resources, such as low- and middle-income countries (LMICs). LMICs have many barriers in the care continuum of cardiovascular diseases (CVD), and big portion of these barriers come from scarcity of resources, mainly financial and human power constraints. AI/ML could potentially improve healthcare delivery if appropriately applied in these countries. Expectedly, the current literature lacks original articles about AI/ML originating from these countries. It is important to start early with a stepwise approach to understand the obstacles these countries face in order to develop AI/ML-based solutions. This could be detrimental to many patients' lives, in addition to other expected advantages in other sectors, including the economy sector. In this report, we aim to review what is known about AI/ML in cardiovascular medicine, and to discuss how it could benefit LMICs.
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Affiliation(s)
- Mohamad S Alabdaljabar
- Department of Internal Medicine, Mayo Clinic, Rochester, MN, USA,College of Medicine, Alfaisal University, Riyadh, Saudi Arabia
| | - Babar Hasan
- Sindh Institute of Urology and Transplantation (SIUT), Karachi, Pakistan
| | | | - Joseph F Maalouf
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN, USA,Department of Medicine, Sheikh Shakhbout Medical City, Abu Dhabi, United Arab Emirates
| | - Naser M Ammash
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN, USA,Department of Medicine, Sheikh Shakhbout Medical City, Abu Dhabi, United Arab Emirates
| | - Shahrukh K Hashmi
- Department of Medicine, Sheikh Shakhbout Medical City, Abu Dhabi, United Arab Emirates,Division of Hematology, Department of Medicine, Mayo Clinic, Rochester, MN, USA,Correspondence: Shahrukh K Hashmi, Department of Medicine, SSMC, Abu Dhabi, United Arab Emirates, Email
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Bandoli G, Hayes S, Delker E. Low to Moderate Prenatal Alcohol Exposure and Neurodevelopmental Outcomes: A Narrative Review and Methodological Considerations. Alcohol Res 2023; 43:01. [PMID: 36950180 PMCID: PMC10027299 DOI: 10.35946/arcr.v43.1.01] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/22/2023] Open
Abstract
PURPOSE Although abstinence is recommended in pregnancy, many pregnancies are exposed to alcohol. Observational studies of the effects of low to moderate prenatal alcohol exposure (PAE) and neurodevelopmental outcomes have yielded inconsistent results, with some studies finding an increased risk of adverse neurobehavioral and cognitive outcomes, and other studies finding no changes or reduced risk of the same outcomes. The purpose of this narrative review is to summarize these inconsistencies and apply a methodological framework to discuss how different parameters contribute to the findings. The authors also provide recommendations on how to advance future research in this area. SEARCH METHODS The PubMed, Web of Science, and Embase databases were searched, along with reference lists of selected systematic reviews and meta-analyses. Search terms used were (infant or child or children or adolescent or offspring) AND (low or light or mild or moderate or low-to-moderate) AND (drinking or alcohol or drinks) AND (pregnancy or prenatal or fetal) AND (neurodevelopment or behavioral or psychological or cognitive or developmental) NOT (mice or rat or fish or animal) NOT (meta-analysis or review). Peer-reviewed original research studies were included if they analyzed associations between an exposure defined and characterized as low/light or moderate PAE with offspring neurodevelopmental outcomes. Animal studies, studies that did not provide clear cutoff points to classify PAE categories, studies lacking an abstinence control group, and studies that did not present a multivariable-adjusted measure of association were excluded. SEARCH RESULTS The searches identified 2,422 papers, with 36 papers meeting eligibility criteria. These studies were carried out across nine countries and included samples ranging from approximately 500 to 40,000 participants. Cognitive, academic, socioemotional, and behavioral outcomes were assessed from infancy through age 19. DISCUSSION AND CONCLUSION When the findings from the selected articles were summarized by geographic region, exposure definition, or neurodevelopmental outcome, no consistent observations or patterns emerged between low to moderate PAE and offspring outcomes. Although some studies found positive (i.e., beneficial) associations between low to moderate PAE and outcomes (primarily outcomes related to cognition) and others found negative (i.e., detrimental) associations (primarily for behavioral outcomes), most findings were null (i.e., showed no effect of PAE). The heterogeneity in study results is likely due to methodological issues, including residual confounding, effect measure modification, and exposure misclassification that make synthesis of studies difficult. Alternative study designs, including longitudinal trajectory analysis, sibling design, negative controls, and instrumental variable analyses, may reduce biases and are discussed. To date, the consequences of light to moderate levels of PAE on neurodevelopment remain unresolved; studies that advance methodological rigor will be important contributions to the field.
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Affiliation(s)
- Gretchen Bandoli
- Department of Pediatrics, University of California San Diego, La Jolla, California
| | - Shana Hayes
- Department of Pediatrics, University of California San Diego, La Jolla, California
| | - Erin Delker
- Department of Pediatrics, University of California San Diego, La Jolla, California
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Zhou G, Li Q. Long-term use of ultra- low-dose mifepristone for uterine leiomyoma control and safety discussion: A case report. Medicine (Baltimore) 2022; 101:e32413. [PMID: 36595976 PMCID: PMC9803439 DOI: 10.1097/md.0000000000032413] [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] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
RATIONALE In recent years, many clinical trials have used low-dose mifepristone to control uterine fibroids, some of which have achieved good results. However, according to the classic concept, long-term use of mifepristone could induce malignant transformation of the endometrium, and the effect of ultra-low-dose of mifepristone on uterine fibroids is still uncertain. Researchers are short on cases of uterine fibroids treated with mifepristone for long periods (more than a year). PATIENT CONCERNS A 47-year-old woman went to the hospital because of anemia. DIAGNOSES The patient was diagnosed with uterine leiomyoma. INTERVENTIONS The patient refused the suggestion of surgery, she was continuously treated with an ultra-low-dose (12.5 mg per 5 days) of mifepristone monotherapy for 4 years. OUTCOMES The uterine leiomyoma was stable, anemia and other symptoms disappeared, and the menstrual cycle, liver and kidney function, and tumor markers were normal. LESSONS Judging from our case, long-term, ultra-low-dose mifepristone for uterine fibroids treatment was safe and more effective than conventional therapy.
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Affiliation(s)
- Guangdi Zhou
- MOE-Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital, Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Qin Li
- Department of Obstetrics and Gynecology, Shanghai Changhai Hospital, China
- * Correspondence: Qin Li, Department of Obstetrics and Gynecology, Shanghai Changhai Hospital, No.168 Changhai Road, Yangpu District, Shanghai 200433, China (e-mail: )
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Angius L, Merlini M, Hopker J, Bianchi M, Fois F, Piras F, Cugia P, Russell J, Marcora SM. Physical and Mental Fatigue Reduce Psychomotor Vigilance in Professional Football Players. Int J Sports Physiol Perform 2022; 17:1391-8. [PMID: 35477898 DOI: 10.1123/ijspp.2021-0387] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Revised: 02/16/2022] [Accepted: 03/07/2022] [Indexed: 12/16/2022]
Abstract
PURPOSE Professional football players experience both physical and mental fatigue (MF). The main aims of this randomized crossover study were to investigate the effect of MF on repeated-sprint ability (RSA) and the effects of both physical fatigue and MF on psychomotor vigilance. METHODS Seventeen male professional football players performed 10 maximal 20-m shuttle sprints interspaced by incomplete recovery (RSA test). Running speed, heart rate, brain oxygenation, and rating of perceived exertion were monitored during each sprint. The RSA test was preceded by either a 30-minute Stroop task to induce MF or by watching a documentary for 30 minutes (control [CON]) in a randomized counterbalanced order. Participants performed a psychomotor vigilance test at baseline, after the cognitive task (MF or CON), and after the RSA test. RESULTS Heart rate and rating of perceived exertion significantly increased, while running speed and brain oxygenation significantly decreased over the repeated sprints (P < .001) with no significant differences between conditions. Response speed during the psychomotor vigilance test significantly declined after the Stroop task but not after CON (P = .001). Response speed during the psychomotor vigilance test declined after the RSA test in both conditions (P < .001) and remained lower in the MF condition compared to CON (P = .012). CONCLUSIONS MF does not reduce RSA. However, the results of this study suggest that physical fatigue and MF have negative and cumulative effects on psychomotor vigilance. Therefore, strategies to reduce both physical fatigue and MF should be implemented in professional football players.
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Bell LR, Gabbett TJ, Davis GM, Wallen MP, O’Brien BJ. Stubborn Exercise Responders-Where to Next? Sports (Basel) 2022; 10:sports10060095. [PMID: 35736835 PMCID: PMC9229615 DOI: 10.3390/sports10060095] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2022] [Revised: 06/03/2022] [Accepted: 06/08/2022] [Indexed: 11/17/2022] Open
Abstract
There is a wide variance in the magnitude of physiological adaptations after resistance or endurance training. The incidence of “non” or “poor” responders to training has been reported to represent as high as 40% of the project’s sample. However, the incidence of poor responders to training can be ameliorated with manipulation of either the training frequency, intensity, type and duration. Additionally, global non-response to cardio-respiratory fitness training is eliminated when evaluating several health measures beyond just the target variables as at least one or more measure improves. More research is required to determine if altering resistance training variables results in a more favourable response in individuals with an initial poor response to resistance training. Moreover, we recommend abandoning the term “poor” responders, as ultimately the magnitude of change in cardiorespiratory fitness in response to endurance training is similar in “poor” and “high” responders if the training frequency is subsequently increased. Therefore, we propose “stubborn” responders as a more appropriate term. Future research should focus on developing viable physiological and lifestyle screening tests that identify likely stubborn responders to conventional exercise training guidelines before the individual engages with training. Exerkines, DNA damage, metabolomic responses in blood, saliva and breath, gene sequence, gene expression and epigenetics are candidate biomarkers that warrant investigation into their relationship with trainability. Crucially, viable biomarker screening tests should show good construct validity to distinguish between different exercise loads, and possess excellent sensitivity and reliability. Furthermore “red flag” tests of likely poor responders to training should be practical to assess in clinical settings and be affordable and non-invasive. Early identification of stubborn responders would enable optimization of training programs from the onset of training to maintain exercise motivation and optimize the impact on training adaptations and health.
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Affiliation(s)
- Leo R. Bell
- Institute of Health and Wellbeing, Federation University, Mount Helen, VIC 3350, Australia; (L.R.B.); (T.J.G.); (G.M.D.); (M.P.W.)
| | - Tim J. Gabbett
- Institute of Health and Wellbeing, Federation University, Mount Helen, VIC 3350, Australia; (L.R.B.); (T.J.G.); (G.M.D.); (M.P.W.)
- Gabbett Performance Solutions, Brisbane, QLD 4011, Australia
| | - Gregory M. Davis
- Institute of Health and Wellbeing, Federation University, Mount Helen, VIC 3350, Australia; (L.R.B.); (T.J.G.); (G.M.D.); (M.P.W.)
| | - Matthew P. Wallen
- Institute of Health and Wellbeing, Federation University, Mount Helen, VIC 3350, Australia; (L.R.B.); (T.J.G.); (G.M.D.); (M.P.W.)
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Adelaide, SA 5000, Australia
| | - Brendan J. O’Brien
- Institute of Health and Wellbeing, Federation University, Mount Helen, VIC 3350, Australia; (L.R.B.); (T.J.G.); (G.M.D.); (M.P.W.)
- Correspondence:
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Imiolczyk JP, Brunner U, Imiolczyk T, Freislederer F, Endell D, Scheibel M. Reverse Shoulder Arthroplasty for Proximal Humerus Head-Split Fractures-A Retrospective Cohort Study. J Clin Med 2022; 11:jcm11102835. [PMID: 35628961 PMCID: PMC9145800 DOI: 10.3390/jcm11102835] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2022] [Revised: 05/10/2022] [Accepted: 05/12/2022] [Indexed: 12/04/2022] Open
Abstract
Head-split fractures are proximal humerus fractures (PHF) that result from fracture lines traversing the articular surface. While head-split fractures are rare, surgical treatment of these complex injuries can be extremely challenging and is associated with high rates of complications. Treatment using primary reverse shoulder arthroplasty (RSA) has been associated with moderate complication rates and reproducible clinical results. The aim of this study was to evaluate clinical and radiographic outcomes, and complication rates of RSA for head-split PHF. Twenty-six patients were evaluated based on Constant Score (CS) and range of motion of both shoulders and Subjective Shoulder Value (SSV). Radiographic analysis evaluated tuberosity healing, prosthetic loosening and scapular notching. Patients achieved good clinical results with a CS of 73.7 points and SSV of 82% after a mean follow-up of 50 months. The relative CS comparing operated versus the unaffected shoulder was 92%. Greater tuberosity healing was achieved in 61%. Patients who suffered a high-energy trauma reached a significantly greater functional outcome. Patients who suffered multifragmentation to the humeral head performed the worst. There were no cases of loosening; scapular notching was visible in two cases. The complication rate was 8%. RSA is an adequate treatment option with for head-split PHF in elderly patients.
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Affiliation(s)
- Jan-Philipp Imiolczyk
- Center for Musculoskeletal Surgery, Charité-Universitaetsmedizin, 13353 Berlin, Germany
- Correspondence: (J.-P.I.); (M.S.)
| | - Ulrich Brunner
- Department of Trauma and Orthopedic Surgery, Krankenhaus Agatharied, 83734 Hausham, Germany;
| | - Tankred Imiolczyk
- Department of Mathematics, University of Mannheim, 68131 Mannheim, Germany;
| | - Florian Freislederer
- Department of Shoulder and Elbow Surgery, Schulthess Clinic, 8008 Zurich, Switzerland; (F.F.); (D.E.)
| | - David Endell
- Department of Shoulder and Elbow Surgery, Schulthess Clinic, 8008 Zurich, Switzerland; (F.F.); (D.E.)
| | - Markus Scheibel
- Center for Musculoskeletal Surgery, Charité-Universitaetsmedizin, 13353 Berlin, Germany
- Department of Shoulder and Elbow Surgery, Schulthess Clinic, 8008 Zurich, Switzerland; (F.F.); (D.E.)
- Correspondence: (J.-P.I.); (M.S.)
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Nukana RP, Rusyati LMM, Praharsini GAA, Winaya KK, Suryawati N, Karna NLPRV. Association of testosterone level with melasma in men: a case-control study in Indonesia. Pan Afr Med J 2022; 43:194. [PMID: 36942149 PMCID: PMC10024555 DOI: 10.11604/pamj.2022.43.194.37435] [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: 09/19/2022] [Accepted: 12/09/2022] [Indexed: 12/23/2022] Open
Abstract
Introduction melasma is a common acquired hypermelanosis which occurs mostly in face that caused by many factors. One of the pathogenesis of melasma in men is affected by testosterone. This study aimed to investigate the relationship between testosterone levels and melasma in men and its association with the severity of melasma as measured by the melasma area and severity index (MASI) score. Methods a case-control study involving 30 subjects with melasma and 30 subjects without melasma who were treated at the outpatient clinic of Dermatovenereology of Ngoerah General Hospital from June to August 2022. Descriptive statistical analysis is to determine frequencies and percentages. Bivariate analysis was used to find any risk factor between testosterone level and melasma. Data obtained from the two groups then analyzed for correlation between the MASI score and testosterone levels. Results mean age of the subjects in the melasma group was 43.83±6.30 and in control group was 43.80±6.09. Mean testosterone level in the melasma group (7.55±1.77) was significantly lower than the control group (21.07±6.65; p = 0.001). Subject with testosterone level ≥8.92 nmol/L has 6.9 times risk of melasma compare to control (aOR: 6.986, 95% CI 1.905-25.622; p = 0.003). Conclusion low testosterone levels possibly have a role in pathogenesis of melasma in men.
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Affiliation(s)
- Ratih Purnamasari Nukana
- Department of Dermatology and Venereology, Faculty of Medicine Udayana University, Ngoerah General Hospital, Denpasar, Bali, Indonesia
| | - Luh Made Mas Rusyati
- Department of Dermatology and Venereology, Faculty of Medicine Udayana University, Ngoerah General Hospital, Denpasar, Bali, Indonesia
- Corresponding author: Luh Made Mas Rusyati, Department of Dermatology and Venereology, Faculty of Medicine Udayana University, Ngoerah General Hospital, Denpasar, Bali, Indonesia.
| | - Gusti Ayu Agung Praharsini
- Department of Dermatology and Venereology, Faculty of Medicine Udayana University, Ngoerah General Hospital, Denpasar, Bali, Indonesia
| | - Ketut Kwartantaya Winaya
- Department of Dermatology and Venereology, Faculty of Medicine Udayana University, Ngoerah General Hospital, Denpasar, Bali, Indonesia
| | - Nyoman Suryawati
- Department of Dermatology and Venereology, Faculty of Medicine Udayana University, Ngoerah General Hospital, Denpasar, Bali, Indonesia
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Smith RM, Lautenbach E, Omulo S, Araos R, Call DR, Kumar GCP, Chowdhury F, McDonald CL, Park BJ. Human Colonization With Multidrug-Resistant Organisms: Getting to the Bottom of Antibiotic Resistance. Open Forum Infect Dis 2021; 8:ofab531. [PMID: 34805441 DOI: 10.1093/ofid/ofab531] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2021] [Accepted: 10/14/2021] [Indexed: 11/14/2022] Open
Affiliation(s)
- Rachel M Smith
- Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Ebbing Lautenbach
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Sylvia Omulo
- Paul G. Allen School for Global Animal Health, Washington State University, Pullman, Washington, USA
| | - Rafael Araos
- Instituto de Ciencias e Innovación en Medicina Universidad del Desarrollo, Santiago, Chile
| | - Douglas R Call
- Paul G. Allen School for Global Animal Health, Washington State University, Pullman, Washington, USA
| | | | | | | | - Benjamin J Park
- Centers for Disease Control and Prevention, Atlanta, Georgia, USA
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12
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Rodriguez-Lopez C, Alcazar J, Sanchez-Martin C, Baltasar-Fernandez I, Ara I, Csapo R, Alegre LM. Neuromuscular adaptations after 12 weeks of light- vs. heavy-load power-oriented resistance training in older adults. Scand J Med Sci Sports 2021; 32:324-337. [PMID: 34618979 DOI: 10.1111/sms.14073] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [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: 04/22/2021] [Revised: 10/02/2021] [Accepted: 10/05/2021] [Indexed: 12/24/2022]
Abstract
This study aimed to determine the specific adaptations provoked by power-oriented resistance training using light (LL-PT, 40% 1-RM) vs. heavy (HL-PT, 80% 1-RM) loads in older adults. Using a randomized within-subject study design, 45 older adults (>65 years) completed an 8-week control period (CTR) followed by 12 weeks of unilateral LL-PT vs. HL-PT on a leg press. The 1-RM, theoretical force at zero velocity (F0 ), maximal unloaded velocity (V0 ), and maximal muscle power (Pmax ) were determined through a force-velocity relationship test. Isometrically, the rate of force development (RFD) and the corresponding muscle excitation of the knee extensor muscles were assessed. In addition, muscle cross-sectional area (CSA) and architecture of two quadriceps muscles were determined. Changes after CTR, LL-PT and HL-PT were compared using linear mixed models. HL-PT provoked greater improvements in 1-RM and F0 (effect size (ES) = 0.55-0.68; p < 0.001) than those observed after LL-PT (ES = 0.27-0.47; p ≤ 0.001) (post hoc treatment effect, p ≤ 0.057). By contrast, ES of changes in V0 was greater in LL-PT compared to HL-PT (ES = 0.71, p < 0.001 vs. ES = 0.39, p < 0.001), but this difference was not statistically significant. Both power training interventions elicited a moderate increase in Pmax (ES = 0.65-0.69, p < 0.001). Only LL-PT improved early RFD (ie, ≤100 ms) and muscle excitation (ES = 0.36-0.60, p < 0.05). Increased CSA were noted after both power training programs (ES = 0.13-0.35, p < 0.035), whereas pennation angle increased only after HL-PT (ES = 0.37, p = 0.004). In conclusion, HL-PT seems to be more effective in improving the capability to generate large forces, whereas LL-PT appears to trigger greater gains in movement velocity in older adults. However, both interventions promoted similar increases in muscle power as well as muscle hypertrophy.
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Affiliation(s)
- Carlos Rodriguez-Lopez
- GENUD Toledo Research Group, Universidad de Castilla-La Mancha, Toledo, Spain.,CIBER of Frailty and Healthy Aging (CIBERFES), Madrid, Spain
| | - Julian Alcazar
- GENUD Toledo Research Group, Universidad de Castilla-La Mancha, Toledo, Spain.,CIBER of Frailty and Healthy Aging (CIBERFES), Madrid, Spain
| | - Coral Sanchez-Martin
- GENUD Toledo Research Group, Universidad de Castilla-La Mancha, Toledo, Spain.,CIBER of Frailty and Healthy Aging (CIBERFES), Madrid, Spain
| | - Ivan Baltasar-Fernandez
- GENUD Toledo Research Group, Universidad de Castilla-La Mancha, Toledo, Spain.,CIBER of Frailty and Healthy Aging (CIBERFES), Madrid, Spain
| | - Ignacio Ara
- GENUD Toledo Research Group, Universidad de Castilla-La Mancha, Toledo, Spain.,CIBER of Frailty and Healthy Aging (CIBERFES), Madrid, Spain
| | - Robert Csapo
- Centre for Sport Science and University Sports, University of Vienna, Vienna, Austria
| | - Luis M Alegre
- GENUD Toledo Research Group, Universidad de Castilla-La Mancha, Toledo, Spain.,CIBER of Frailty and Healthy Aging (CIBERFES), Madrid, Spain
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13
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Duque V, Chaverra L, Cury J, Portela MC, Suárez-Escudero JC. Visual and neurological impairment post-dysfunction in the ventricle-peritoneal shunt system: A case report. ACTA ACUST UNITED AC 2021; 41:17-28. [PMID: 33761186 DOI: 10.7705/biomedica.5657] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2020] [Indexed: 11/29/2022]
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Martiniello N, Wittich W. The association between tactile, motor and cognitive capacities and braille reading performance: a scoping review of primary evidence to advance research on braille and aging. Disabil Rehabil 2020; 44:2515-2536. [PMID: 33147427 DOI: 10.1080/09638288.2020.1839972] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
PURPOSE As the prevalence of age-related visual impairment increases, a greater understanding of the physiological and cognitive capacities that are recruited during braille reading and the potential implications of age-related declines is required. METHODS This scoping review aimed to identify and describe primary studies exploring the relationship between tactile, motor and cognitive capacities and braille reading performance, the instruments used to measure these capacities, and the extent to which age is considered within these investigations. English peer-reviewed articles exploring the relationship between these capacities and braille reading performance were included. Articles were screened by two researchers, and 91% agreement was achieved (kappa = 0.84 [0.81, 0.87], p < 0.01). RESULTS 2405 articles were considered of which 36 met the inclusion criteria. Fifteen investigated the relationship between tactile capacities and braille reading performance, 25 explored motor capacities, and 5 considered cognitive capacities. Nineteen instruments were used to measure tactile capacity, 4 for motor dexterity, and 7 for cognitive capacity. These studies focus on younger participants and on those who learned braille early in life. CONCLUSIONS Although this overview underscores the importance of tactile perception and bimanual reading, future research is needed to explore the unique needs of older adults who learn braille later in life.IMPLICATIONS FOR REHABILITATIONThe studies in this review underscore the importance of developing both haptic tactile perception and efficient hand reading patterns early in the braille learning process.Practitioners should consider whether specific pre-braille readiness activities can be used to address the unique needs of older adults who may experience tactile, motor or cognitive declines.Most of the studies in this review require replication before they should serve as reliable clinical guidelines; however, braille reading (like print) is a complex process that draws on multiple capacities that should be developed in unison.The studies in this review focus heavily on younger participants and on those who learned braille early in life, and highlight the need for future research on braille and aging.
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Affiliation(s)
- Natalina Martiniello
- École d'optométrie, Université de Montréal, Montréal, QC, Canada.,CRIR/Centre de réadaptation Lethbridge-Layton-Mackay du CIUSSS Centre-Ouest-de-l'Île-de-Montréal, Montréal, QC, Canada
| | - Walter Wittich
- École d'optométrie, Université de Montréal, Montréal, QC, Canada.,CRIR/Centre de réadaptation Lethbridge-Layton-Mackay du CIUSSS Centre-Ouest-de-l'Île-de-Montréal, Montréal, QC, Canada.,CRIR/Institut Nazareth et Louis-Braille du CISSS de la Montérégie-Centre, Montréal, QC, Canada
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15
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Ribeiro LSDL, Pinto VDC. Discrepancies in the Brazilian tobacco production chain: raw inputs, international trade and legal cigarette production. Tob Control 2020; 29:s310-s318. [PMID: 32843500 DOI: 10.1136/tobaccocontrol-2019-055265] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [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] [Received: 08/06/2019] [Revised: 10/21/2019] [Accepted: 10/28/2019] [Indexed: 11/03/2022]
Abstract
BACKGROUND The significant market share of illicit cigarettes in Brazil is well established in the literature, nonetheless lacking clarity in terms of its actual size. Paraguay has a paramount role in this discussion, acting both as a supplier of illegal tobacco products to Brazil and as buyer of inputs from Brazil. A proper analysis of the illicit cigarette market in Brazil necessarily involves a deeper discussion of the Paraguayan production chain and its interaction with the Brazilian market. METHODS International data were used to establish the bilateral legal trade pattern of tobacco-related products between Paraguay and Brazil, including inputs and final outputs. Inspired by the technical requirements methodology, available unmanufactured tobacco within Brazil was obtained by adding-up domestic production with net imports. Its historical behaviour was compared with legal cigarette production patterns within Brazil. Supposing rational agents, these two links of the Brazilian cigarette production chain should behave similarly: for lower final usage, less domestically available supply. Any discrepancies would suggest something abnormal in the production chain. RESULTS Brazil is a relevant legal supplier of intermediate goods for the Paraguayan tobacco complex and has an irrelevant position as legal buyer of Paraguayan tobacco-related goods (either inputs or final goods). Paraguayan net imports of production inputs seem to be abnormally high for their legal needs. In Brazil, a clear discrepancy between domestically available unmanufactured tobacco (input) and tax-based cigarette production (output) emerged throughout the years and, even more striking, has been growing over the years. CONCLUSIONS Excessive cigarette production inputs in Paraguay suggest a potential oversupply of cigarettes in that country-likely diverted to illicit trade. Likewise, discrepancies in the Brazilian tobacco production chain are also evidence of illicit tobacco trading in Brazil-not necessarily of final products. A deeper analysis of the Brazil/Paraguay tobacco supply chain would be welcomed given the likely operation of these two countries as a single 'production/consumption hub' of both legal and illegal products (either inputs or final tobacco products). Public policies should foster controls not only on cigarettes but also on raw inputs for their production.
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Shallis RM, Podoltsev NA, Gowda L, Zeidan AM, Gore SD. Cui bono? Finding the value of allogeneic stem cell transplantation for lower-risk myelodysplastic syndromes. Expert Rev Hematol 2020; 13:447-460. [PMID: 32182435 DOI: 10.1080/17474086.2020.1744433] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
Introduction: The myelodysplastic syndromes (MDS) vary in their risk of disease progression; progression includes increasingly severe bone marrow failure, reclassification as acute myeloid leukemia (AML), and death. Prognostic tools guide recommendations for allogeneic stem cell transplantation (alloSCT), the only curative option. AlloSCT is typically reserved for patients with higher-risk MDS as defined by existing prognostic tools, although additional clinical and biological factors in lower-risk patients may influence this dogma.Areas covered: This review discusses the current understanding of MDS risk stratification as it pertains to the use of alloSCT in subpopulations of MDS patients with a particular focus on the use of alloSCT in patients with lower-risk disease.Expert commentary: Though high-quality data are lacking, some lower-risk MDS patients may benefit from alloSCT, which offers the only prospect of cure. Understanding the etiologic role and prognostic impact of recurring genetic events may improve existing risk stratification and become integral facets of prognostic schemata. The identification of additional factors influencing the prognoses of patients currently lumped together as 'lower-risk' will likewise improve the selection of MDS patients for early intervention or aggressive therapies such as alloSCT.
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Affiliation(s)
- Rory M Shallis
- Section of Hematology, Department of Internal Medicine, Yale University School of Medicine, New Haven, CT, USA.,Yale Cancer Center, New Haven, CT, USA
| | - Nikolai A Podoltsev
- Section of Hematology, Department of Internal Medicine, Yale University School of Medicine, New Haven, CT, USA.,Yale Cancer Center, New Haven, CT, USA
| | - Lohith Gowda
- Section of Hematology, Department of Internal Medicine, Yale University School of Medicine, New Haven, CT, USA.,Yale Cancer Center, New Haven, CT, USA
| | - Amer M Zeidan
- Section of Hematology, Department of Internal Medicine, Yale University School of Medicine, New Haven, CT, USA.,Yale Cancer Center, New Haven, CT, USA
| | - Steven D Gore
- Section of Hematology, Department of Internal Medicine, Yale University School of Medicine, New Haven, CT, USA.,Yale Cancer Center, New Haven, CT, USA
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Zoehner G, Miclea A, Salmen A, Kamber N, Diem L, Friedli C, Bagnoud M, Ahmadi F, Briner M, Sédille-Mostafaie N, Kilidireas C, Stefanis L, Chan A, Hoepner R, Evangelopoulos ME. Reduced serum immunoglobulin G concentrations in multiple sclerosis: prevalence and association with disease-modifying therapy and disease course. Ther Adv Neurol Disord 2019; 12:1756286419878340. [PMID: 31632461 PMCID: PMC6767745 DOI: 10.1177/1756286419878340] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2019] [Accepted: 08/18/2019] [Indexed: 12/15/2022] Open
Abstract
Background: In multiple sclerosis (MS), the frequency of hypogammaglobulinemia is
unknown. We aimed to evaluate the frequency of reduced immunoglobulin (Ig)
concentrations and its association with immunotherapy and disease course in
two independent MS cohorts. Methods: In our retrospective cross-sectional study, MS patients and control patients
with head or neck pain from Bern University Hospital (Bern, Switzerland) and
Eginition University Hospital (Athens, Greece) were included. The lower
limits of normal (LLN) for serum Ig concentration were IgG < 700 mg/dl,
IgM < 40 mg/dl, and IgA < 70 mg/dl. Mann–Whitney U
test, analysis of variance test, and multiple linear regression analysis
were employed. Results: In total, 327 MS patients were retrospectively identified (Bern/Athens:
n = 226/101). Serum IgG concentrations were frequently
under LLN in both MS cohorts (Bern/Athens: 15.5%/14.9%), even when
considering only untreated patients (Bern/Athens: 7.9%/8.6%). MS patients
(n = 327) were significantly more likely to have IgG
concentrations below LLN and below 600 mg/dl in comparison with controls
(n = 58) (p = 0.015 and 0.047,
respectively). Between both patient groups, no significant differences were
found in frequencies of IgA and IgM concentrations under LLN
[n (MS patients/controls): IgA 203/30, IgM 224/24].
Independently of age, secondary progressive MS patients had lower IgG
concentrations than relapsing–remitting and primary progressive patients
(both: p ⩽ 0.01). After adjusting for sex, age, and disease
course, IgG concentrations were lower in patients treated with rituximab
(p = 0.001; n = 42/327), intravenous
corticosteroids (p < 0.001;
n = 16/327), natalizumab (p < 0.001;
n = 48/327), and fingolimod
(p = 0.003; n = 6/327). Conclusion: Our study demonstrated high prevalence rates of reduced serum IgG
concentrations in MS patients with and without disease-modifying treatments.
The significance of lower IgG concentrations at the levels noted is unclear
considering that infections or interference with antibody production
generally occur when IgG levels are much lower, at or below 400 mg/dl.
However, the information is useful to monitor IgG levels especially with
anti-B-cell therapies and consider IgG substitution when levels drop below
400 mg/dl.
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Affiliation(s)
- Greta Zoehner
- Department of Neurology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Andrei Miclea
- Department of Neurology, Inselspital, Bern University Hospital, University of Bern. Freiburgstrasse, Bern, CH-3010, Switzerland
| | - Anke Salmen
- Department of Neurology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Nicole Kamber
- Department of Neurology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Lara Diem
- Department of Neurology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Christoph Friedli
- Department of Neurology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Maud Bagnoud
- Department of Neurology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Farhad Ahmadi
- Department of Neurology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Myriam Briner
- Department of Neurology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Nazanin Sédille-Mostafaie
- University Institute of Clinical Chemistry, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Constantinos Kilidireas
- Department of Neurology, Eginition University Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Leonidas Stefanis
- Department of Neurology, Eginition University Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Andrew Chan
- Department of Neurology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Robert Hoepner
- Department of Neurology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
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Abstract
Purpose: Coping strategies employed by people with visual disability can influence their quality of life (QoL). We aimed to assess coping in patients with low vision or blindness. Methods: In this descriptive cross sectional study, 60 patients (25–65 years) with <6/18 best-corrected vision (BCVA) in the better eye and vision loss since ≥6 months were recruited after the institutional ethics clearance and written informed consent. Age, gender, presence of other chronic illness, BCVA, coping strategies (Proactive Coping Inventory, Hindi version), and vision-related quality of life (VRQoL; Hindi version of IND-VFQ33) were recorded. Range, mean (standard deviation) for continuous and proportion for categorical variables. Pearson correlation looked at how coping varied with age and with VRQoL. The analysis of variance (ANOVA) and t-test compared coping scores across categorical variables. Statistical significance was taken at P < 0.05. Results: Sixty patients fulfilled inclusion criteria. There were 33 (55%) women; 25 (41.7%) had low vision, 5 (8.3%) had economic blindness, and 30 (50.0%) had social blindness; 27 (45.0%) had a co-morbid chronic illness. Total coping score was 142 ± 26.43 (maximum 217). VRQoL score (maximum 100) was 41.9 ± 15.98 for general functioning; 32.1 ± 12.15 for psychosocial impact, and 41.1 ± 17.30 for visual symptoms. Proactive coping, reflective coping, strategic planning, and preventive coping scores correlated positively with VRQoL in general functioning and psychosocial impact. Conclusion: Positive coping strategies are associated with a better QoL. Ophthalmologists who evaluate visual disability should consider coping mechanisms that their patients employ and should refer them for counseling and training in more positive ways of coping.
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Affiliation(s)
- Puja Rai
- Department of Ophthalmology, University College of Medical Sciences and Guru Teg Bahadur Hospital, Delhi - 95, India
| | - Jolly Rohatgi
- Department of Ophthalmology, University College of Medical Sciences and Guru Teg Bahadur Hospital, Delhi - 95, India
| | - Upreet Dhaliwal
- Department of Ophthalmology, University College of Medical Sciences and Guru Teg Bahadur Hospital, Delhi - 95, India
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Peters B, Higger M, Quivira F, Bedrick S, Dudy S, Eddy B, Kinsella M, Memmott T, Wiedrick J, Fried-Oken M, Erdogmus D, Oken B. Effects of simulated visual acuity and ocular motility impairments on SSVEP brain-computer interface performance: An experiment with Shuffle Speller. Brain Comput Interfaces (Abingdon) 2018; 5:58-72. [PMID: 30895198 DOI: 10.1080/2326263x.2018.1504662] [Citation(s) in RCA: 8] [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] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Individuals with severe speech and physical impairments may have concomitant visual acuity impairments (VAI) or ocular motility impairments (OMI) impacting visual BCI use. We report on the use of the Shuffle Speller typing interface for an SSVEP BCI copy-spelling task under three conditions: simulated VAI, simulated OMI, and unimpaired vision. To mitigate the effect of visual impairments, we introduce a method that adaptively selects a user-specific trial length to maximize expected information transfer rate (ITR); expected ITR is shown to closely approximate the rate of correct letter selections. All participants could type under the unimpaired and simulated VAI conditions, with no significant differences in typing accuracy or speed. Most participants (31 of 37) could not type under the simulated OMI condition; some achieved high accuracy but with slower typing speeds. Reported workload and discomfort were low, and satisfaction high, under the unimpaired and simulated VAI conditions. Implications and future directions to examine effect of visual impairment on BCI use is discussed.
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Affiliation(s)
- Betts Peters
- Institute on Development & Disability, Oregon Health & Science University, Portland, OR
| | - Matt Higger
- Psychiatry Neuroimaging Laboratory, Brigham and Women's Hospital and Harvard Medical School, Boston, MA.,Electrical & Computer Engineering, Northeastern University, Boston, MA
| | - Fernando Quivira
- Electrical & Computer Engineering, Northeastern University, Boston, MA
| | - Steven Bedrick
- Center for Spoken Language Understanding, Oregon Health & Science University, Portland, OR
| | - Shiran Dudy
- Center for Spoken Language Understanding, Oregon Health & Science University, Portland, OR
| | - Brandon Eddy
- Institute on Development & Disability, Oregon Health & Science University, Portland, OR
| | - Michelle Kinsella
- Institute on Development & Disability, Oregon Health & Science University, Portland, OR
| | - Tab Memmott
- Departments of Neurology, Behavioral Neuroscience, and Biomedical Engineering, Oregon Health & Science University, Portland, OR
| | - Jack Wiedrick
- Biostatistics & Design Program, Oregon Health & Science University, Portland, OR
| | - Melanie Fried-Oken
- Institute on Development & Disability, Oregon Health & Science University, Portland, OR
| | - Deniz Erdogmus
- Electrical & Computer Engineering, Northeastern University, Boston, MA
| | - Barry Oken
- Departments of Neurology, Behavioral Neuroscience, and Biomedical Engineering, Oregon Health & Science University, Portland, OR
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Raknes G, Simonsen P, Småbrekke L. The Effect of Low-Dose Naltrexone on Medication in Inflammatory Bowel Disease: A Quasi Experimental Before-and-After Prescription Database Study. J Crohns Colitis 2018; 12:677-686. [PMID: 29385430 PMCID: PMC5972567 DOI: 10.1093/ecco-jcc/jjy008] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2017] [Accepted: 01/17/2018] [Indexed: 12/23/2022]
Abstract
BACKGROUND AND AIMS Low-dose naltrexone [LDN] is a controversial off-label treatment used by many Crohn's disease [CD] and ulcerative colitis [UC] patients. A small number of preliminary studies indicate that LDN might be beneficial in CD, but evidence is too scarce to demonstrate efficacy. We sought to examine whether initiation of LDN therapy by patients with inflammatory bowel disease [IBD] was followed by changes in dispensing of relevant medication. METHODS We performed a quasi-experimental before-and-after study following a sudden increase in LDN use in the Norwegian population in 2013. IBD patients were identified from among all the patients who had at least one LDN prescription recorded in the Norwegian Prescription Database [NorPD] in 2013. Drug dispensing 2 years before and after the first LDN prescription was compared. RESULTS We identified 582 IBD patients who had received LDN. Of the 256 patients who became persistent LDN users, there were reductions in the number of users for [i] all examined drugs [-12%], [ii] intestinal anti-inflammatory agents [-17%], [iii] other immunosuppressants [-29%], [iv] intestinal corticosteroids [-32%] and [v] aminosalicylates [-17%]. In subgroups of identified CD and UC patients, there were significant reductions in the number of users of intestinal corticosteroids [CD: -44%, UC: -53%] and systemic corticosteroids [UC: -24%]. No significant differences in cumulative defined daily doses were observed. CONCLUSIONS Our findings imply that the initiation of LDN in IBD is followed by reduced dispensing of several drugs considered essential in the treatment of CD and UC.
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Affiliation(s)
- Guttorm Raknes
- Regional Medicines Information and Pharmacovigilance Centre [RELIS], University Hospital of North Norway, Tromsø, Norway,Raknes Research, Ulset, Norway,Corresponding author: Guttorm Raknes, RELIS, Box 79, 9038 Tromsø, Norway. E-mail:
| | | | - Lars Småbrekke
- Department of Pharmacy, Faculty of Health Sciences, UiT – The Arctic University of Norway, Tromsø, Norway
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Abstract
Cancer is increasingly important in low and middle-income settings where infectious diseases are declining. Childhood cancers treated in well-resourced centres have excellent outcomes with more than 80% survival. This success is not reflected in low-income settings where challenges involve every step on the care pathway. Access to diagnosis, delayed presentation, advanced disease, co-morbidities and underlying malnutrition make treatment difficult. Treatments are costly for impoverished families. Yet, the common haematological malignancies (Burkitt lymphoma, Hodgkin lymphoma, non Hodgkin lymphoma) are relatively easy to diagnose and, when managed with simple chemotherapy protocols, give limited but good results. As funding becomes available for cancer research we must ensure that the care and cure of these children is top of the agenda. There is already evidence of improved outcomes in middle-income countries. For others there is a long journey ahead.
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Affiliation(s)
| | | | | | - Lorna Renner
- University of Ghana School of Medicine and Dentistry, Accra, Ghana
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22
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Dos Santos ER, Lopes CT, Maria VLR, de Barros ALBL. Risk factors for decreased cardiac output after coronary artery bypass grafting: a prospective cohort study. Eur J Cardiovasc Nurs 2016; 16:352-359. [PMID: 27888199 DOI: 10.1177/1474515116681373] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [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] [Indexed: 11/16/2022]
Abstract
BACKGROUND No previous study has investigated the predictive risk factors of the nursing diagnosis of risk for decreased cardiac output after coronary artery bypass grafting (CABG). AIMS This study aimed to identify the predictive risk factors of the nursing diagnosis of risk for decreased cardiac output after CABG. METHODS This was a prospective cohort study performed at a cardiac university hospital in São Paulo, Brazil and 257 adult patients undergoing CABG were included. Potential risk factors for low cardiac output in the immediate post-operative period were investigated using the patients' medical records. Univariate analysis and logistic regression were used to identify the predictive risk factors of decreased cardiac output. The area under the receiver operating characteristic curve was calculated as a measure of accuracy. The variables that could not be analysed through logistic regression were analysed through Fisher's exact test. RESULTS One hundred and ninety-five patients had low cardiac output in the immediate post-operative period. The predictive risk factors included age ⩾60 years, decreased left ventricle ejection fraction, not using the radial artery graft, positive fluid balance and post-operative arrhythmia that differed from the pre-operative arrhythmia. This model predicted the outcome with a sensitivity of 62.9%, a specificity of 87.2% and an accuracy of 81.5%. The variables analysed through Fisher's exact test included heart failure, re-exploration and bleeding-related re-exploration. CONCLUSIONS The predictive risk factors for the nursing diagnosis of risk for decreased cardiac output after CABG were found. These results can be used to direct nurses in patient monitoring, staff training and nursing team staffing.
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Affiliation(s)
- Eduarda Ribeiro Dos Santos
- 1 Paulista Nursing School, Federal University of São Paulo (EPE-UNIFESP), Brazil.,2 Faculdade Israelita de Ciências da Saúde Albert Einstein, Brazil
| | - Camila Takao Lopes
- 1 Paulista Nursing School, Federal University of São Paulo (EPE-UNIFESP), Brazil
| | - Vera Lucia Regina Maria
- 1 Paulista Nursing School, Federal University of São Paulo (EPE-UNIFESP), Brazil.,3 Universidade São Camilo, Brazil
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Abstract
INTRODUCTION Low back pain (LBP) is the most common musculoskeletal disease. Monochromatic infrared photo energy (MIPE) and low level laser therapy (LLLT) are light modalities used to reduce pain and increase blood flow. The aim of this study was to compare the effects of the MIPE and LLLT in reducing functional disability and pain as well as improving lumbar range of motion (ROM) in patients with chronic LBP. METHODS Seventy participants with LBP completed the program and were randomly assigned into 2 groups. Group 1 (n = 35) received MIPE and therapeutic exercises. Group 2 (n = 35) received LLLT and therapeutic exercises. Both groups received 2 visits per week for 6 weeks. Outcome measures were functional rating index (FRI), visual analogue scale (VAS) and modified-modified Schober test at baseline and after 6 weeks. RESULTS There were statistically significant improvements in functional disability, pain and lumbar ROM (P < .05) in each group. However, no significant differences were recorded between the groups (P > .05). CONCLUSION Therefore, MIPE and LLLT may play a role in treating chronic LBP and there are no differences between the two modalities in improving functional disability, pain and lumbar ROM in patients with chronic LBP.
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O'Keeffe LM, Greene RA, Kearney PM. The effect of moderate gestational alcohol consumption during pregnancy on speech and language outcomes in children: a systematic review. Syst Rev 2014; 3:1. [PMID: 24383422 PMCID: PMC3892059 DOI: 10.1186/2046-4053-3-1] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2013] [Accepted: 12/05/2013] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Consensus has not been reached on safe alcohol consumption recommendations during pregnancy. The National Institutes for Care and Health Excellence (NICE) in the UK suggest that one to two drinks not more than twice per week is safe. However, the speech and language effects of even low levels of alcohol use among offspring are unknown. The aim of this study was to review systematically the evidence on studies of the effect of low to moderate levels of alcohol consumption during pregnancy (up to 70 grams of alcohol per week) compared to abstinence on speech and language outcomes in children. METHODS Using medical subject headings, PubMed, Web of knowledge, Scopus, Embase, Cinahl and the Cochrane Library were searched from their inception up to March 2012. Case control and cohort studies were included. Two assessors independently reviewed titles, abstracts and full articles, extracted data and assessed quality. RESULTS A total of 1,397 titles and abstracts were reviewed of which 51 full texts were retrieved. Three cohort studies totaling 10,642 women met the inclusion criteria. All three studies, (United States (2) and Australia (1)) indicated that language was not impaired as a result of low to moderate alcohol consumption during pregnancy. Two studies were judged to be of low quality based on a six-item bias classification tool. Due to heterogeneity, results could not be meta-analyzed. CONCLUSION Studies included in this review do not provide sufficient evidence to confirm or refute an association between low to moderate alcohol use during pregnancy and speech and language outcomes in children. High quality, population based studies are required to establish the safety of low to moderate levels of alcohol use such as those set out by the NICE guidelines in the UK.
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Affiliation(s)
- Linda M O'Keeffe
- National Perinatal Epidemiology Centre, Department of Obstetrics and Gynecology, Cork University Maternity Hospital, Cork, Ireland.
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Sahin SH, Cinar SO, Paksoy I, Sut N, Oba S. Comparison between low flow sevoflurane anesthesia and total intravenous anesthesia during intermediate-duration surgery: effects on renal and hepatic toxicity. Hippokratia 2011; 15:69-74. [PMID: 21607040 PMCID: PMC3093149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
BACKGROUND Renal and hepatic dysfunction or injury might be involved by ether based anesthetic and intravenous anesthetic drug or surgical stress. The purpose of this study is to compare the effect of moderate duration low-flow sevoflurane versus total intravenous anesthesia on renal and hepatic functions. PATIENTS AND METHODS Eighty (80) patients between the ages of 25-70 scheduled for elective lumbar disc herniotomy, with an expected operation time of 120-240 min, were enrolled in the study. Anesthesia was induced using remifentanil, propofol and atracurium. Patients were randomly divided into two groups. After intubation, Group S (n=40) received sevoflurane and Group T (n=40) received total intravenous anesthesia with propofol in oxygen and air with a fresh gas flow of 5 L min(?1). Ten minutes after induction the fresh gas flow was decreased to 1L min(?1) in both groups. Serum BUN, creatinine, ALT, AST, LDH and 24 hours excretion of glucose, protein, and creatinine in urine were measured preoperatively and the first three postoperative days. RESULTS Serum BUN at 48 hours, creatinine at 24, 48. hours, and urine glucose at 24, and 48 hours were significantly higher from the preoperative values in Group S (p<0.05). However, serum BUN and creatinin, urine glucose were within the normal range. There were no significant differences in the renal and hepatic function tests between the groups. CONCLUSIONS These results show that the renal and hepatic effect of moderate duration low-flow sevoflurane and total intravenous anesthesia is similar.
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Monga PK, Parwal BP, Rohatgi J, Dhaliwal U. Are current guidelines for categorization of visual impairment in India appropriate? Indian J Ophthalmol 2009; 57:423-6. [PMID: 19861742 PMCID: PMC2812759 DOI: 10.4103/0301-4738.57144] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2008] [Accepted: 03/13/2009] [Indexed: 11/05/2022] Open
Abstract
CONTEXT Visual disability in India is categorized based on severity. Sometimes the disabled person does not fit unambiguously into any of the categories. AIMS To identify and quantify disability that does not fit in the current classification, and propose a new classification that includes all levels of vision. SETTINGS AND DESIGN Retrospective chart review of visual disability awarded in a teaching hospital. MATERIALS AND METHODS The last hundred records of patients who had been classified as visually disabled were screened for vision in both eyes and percentage disability awarded. Data were handled in accordance with the Helsinki Declaration. RESULTS Twenty-one patients had been classified as having 30% disability, seven each had 40% and 75%, and 65 had 100% disability. Eleven of them did not fall into any of the current categories, forcing the disability board to use its own judgment. There was a tendency to over-grade the disability (seven of 11; 63.6%). The classification proposed by us is based on the national program for control of blindness' definition of normal vision (20/20 to 20/60), low vision ( < 20/60 to 20/200), economic blindness ( < 20/200 to 20/400) and social blindness ( < 20/400). It ranges from the mildest disability (normal vision in one eye, low vision in the other) up to the most severe grade (social blindness in both eyes). CONCLUSIONS The current classification of visual disabilities does not include all combinations of vision; some disabled patients cannot be categorized. The classification proposed by us is comprehensive, progresses logically, and follows the definitions of the national program.
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Affiliation(s)
| | - Binay P Parwal
- Department of Medicine, University College of Medical Sciences and Guru Teg Bahadur Hospital, Delhi, India
| | - Jolly Rohatgi
- Department of Ophthalmology, University College of Medical Sciences and Guru Teg Bahadur Hospital, Delhi, India
| | - Upreet Dhaliwal
- Department of Ophthalmology, University College of Medical Sciences and Guru Teg Bahadur Hospital, Delhi, India
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Ameh N, Kene TS, Ameh EA. Computer knowledge amongst clinical year medical students in a resource poor setting. Afr Health Sci 2008; 8:40-43. [PMID: 19357731 PMCID: PMC2408545] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/27/2023] Open
Abstract
OBJECTIVE To study the computer knowledge and desires of clinical year medical students at one of the oldest and largest medical schools in Nigeria. DESIGN A survey using validated structured questionnaires. SETTING Medical school of Ahmadu Bello University, Zaria, Nigeria. SUBJECTS Two hundred and thirty seven clinical year (4th, 5th and 6th years) medical students. OUTCOME MEASURES Computer knowledge, mode of acquiring computer knowledge, regular access to computer, desire for inclusion of computer training in curriculum. RESULTS One hundred twenty (50.6%) students had knowledge of computer technology and it use. Of these, 108 (90%) had no regular access to a computer and none owned a computer; only 32 (26.7%) were sufficiently familiar with computer tools to perform advanced tasks, but 72 (60%) were comfortable with word processing. Seventy two of the 120 students acquired their computer knowledge through self-learning efforts while 45 (37.5%) attended short periods of formal training. Overall, 45.7% of males and 64.5% of females had computer knowledge. The main reason for lack of computer knowledge was lack of time and lack of access to a computer. Eighty percent of all students would like computer education to be included in medical school curriculum. CONCLUSION Knowledge and use of computers amongst clinical year medical students in this setting is low. It is important that computer education be taught to the students to enhance their ability to use electronic information and communicate more effectively using computer resources.
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Affiliation(s)
- Nkeiruka Ameh
- Department of Obstetrics and Gynaecology, Ahmadu Bello Univerity, Zaria, Nigeria.
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Abstract
Low level laser therapy (LLLT) is frequently used in the treatment of wounds, soft tissue injury and in pain management. The exact penetration depth of LLLT in human tissue remains unspecified. Similar uncertainty regarding penetration depth arises in treating animals. This study was designed to test the hypothesis that transmission of LLLT in horses is increased by clipping the hair and/or by cleaning the area to be treated with alcohol, but is unaffected by coat colour. A LLLT probe (810 nm, 500 mW) was applied to the medial aspect of the superficial flexor tendon of seventeen equine forelimbs in vivo. A light sensor was applied to the lateral aspect, directly opposite the laser probe to measure the amount of light transmitted. Light transmission was not affected by individual horse, coat colour or leg. However, it was associated with leg condition (F = 4.42, p = 0.0032). Tendons clipped dry and clipped and cleaned with alcohol, were both associated with greater transmission of light than the unprepared state. Use of alcohol without clipping was not associated with an increase in light transmission. These results suggest that, when applying laser to a subcutaneous structure in the horse, the area should be clipped and cleaned beforehand.
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Affiliation(s)
- Teresa Ryan
- 1The Royal Veterinary College, Hawkshead Lane, North Mymms, Hatfield, Hertfordshire, AL9 7 TA, UK.
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Hutten MMR, Hermens HJ. Relationships between isoinertial lumbar dynamometry parameters and demographic parameters in chronic low back pain patients. Eur Spine J 1998; 7:454-60. [PMID: 9883954 PMCID: PMC3611304 DOI: 10.1007/s005860050108] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
The purpose of this study was to investigate which demographic parameters are most important in relation to lumbar dynamometry performance in patients with chronic low back pain (LBP). Forty-five chronic LBP patients participated in this study. Gender, age, weight and height were determined and a lumbar dynamometry measurement was carried out, using the Isostation B200. Student's t-test, ANOVA techniques and correlation coefficients were used to investigate the relationships between each demographic parameter and lumbar dynamometry performance. Stepwise multiple linear regression analyses were performed afterwards to determine which demographic parameters are most important in relation to lumbar dynamometry performance. Results indicate significant relationships (1) between gender, height, weight and all lumbar dynamometry parameters and (2) between age and three of the six isometric torque parameters. No significant relationship was found between age and maximum velocity parameters. Results of the stepwise multiple linear regression analyses show that the demographic parameters explain 27-47% of the variance in maximum isometric strength parameters and 19-25% of the variance in maximum velocity parameters. Gender is the most important demographic parameter, being related to nearly all maximum isometric torque parameters (percentage explained variance 6-37%) and height is the only important demographic parameter related to the velocity parameters (percentage explained variance 19-25%). Weight and age account for only a small amount of variance in lumbar dynamometry parameters (percentage explained variance 5-7%), meaning that these parameters are non-relevant predictors.
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Affiliation(s)
- M. M. R. Hutten
- Roessingh Research and Development, Roessinghsbleekweg 33b, 7522 AH Enschede, The Netherlands e-mail: , Tel.: +31-53-487 5734, Fax: +31-53-434 0849, , , , NL
| | - H. J. Hermens
- Roessingh Research and Development, Roessinghsbleekweg 33b, 7522 AH Enschede, The Netherlands e-mail: , Tel.: +31-53-487 5734, Fax: +31-53-434 0849, , , , NL
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