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Radiographic knee osteoarthritis severity has no impact on fall risk: the locomotive syndrome and health outcomes in the aizu cohort study (LOHAS): a cross-sectional study. BMC Musculoskelet Disord 2024; 25:298. [PMID: 38627744 PMCID: PMC11020781 DOI: 10.1186/s12891-024-07421-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2024] [Accepted: 04/05/2024] [Indexed: 04/19/2024] Open
Abstract
BACKGROUND To investigate factors that have an impact on the risk of falls and determine whether radiographic knee osteoarthritis (KOA) is a factor involved in falls independent of knee pain, psychological factors, and physical function. METHODS A cross-sectional analysis was conducted on 1083 subjects for the 2009 Locomotive Syndrome and Health Outcomes in the Aizu Cohort Study (LOHAS). A logistic regression analysis was performed to examine the relationship between radiographic KOA and fall history. RESULTS Fall history was significantly associated with the severity of knee pain. Compared to subjects with no knee pain, the odds ratio (OR) was 1.53 times higher in the subjects with mild knee pain (95% confidence interval [CI]: 1.04-2.25), 1.69 times higher in those with moderate knee pain (95%CI: 1.03-2.79), and 2.98 times higher in those with severe knee pain (95%CI: 1.67-5.30). In subjects with depression, the OR was 1.91 (95%CI: 1.25-2.92), and in those with decreased mobility, the OR was 1.70 (95%CI: 1.08-2.69). Age, gender, knee crepitus, BMI, OLST, and sleeping pill use were not significantly associated with fall risk. In a multivariate analysis, radiographic KOA severity was not significantly associated with fall risk (OR 0.81, 95%CI 0.44-1.50 in mild OA; OR 1.10, 95%CI 0.57-2.14 in severe OA). CONCLUSION Knee pain, decreased mobility, and depression, but not the radiographic KOA severity, were significantly associated with a fall risk. Regardless of the individual's radiographic KOA severity, the risk of falls may be reduced by treating his/her knee pain, mobility problems, and/or psychological factors.
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Prognostic impact and survival outcomes of colon perforation in patients with metastatic colorectal cancer: a multicenter retrospective cohort study. Int J Clin Oncol 2024; 29:179-187. [PMID: 38078975 DOI: 10.1007/s10147-023-02444-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Accepted: 11/18/2023] [Indexed: 01/26/2024]
Abstract
BACKGROUND Colon perforation caused by colorectal cancer (CRC) is a fatal condition requiring emergency intervention. For patients with metastatic lesions, surgeons face difficult decisions regarding whether to resect the primary and metastatic lesions. Moreover, there is currently no established treatment strategy for these patients. This study aimed to investigate the clinical practice and long-term outcomes of patients with metastatic CRC diagnosed with the onset of colon perforation. METHODS We performed a population-based multicenter cohort study. Consecutive patients diagnosed with stage IV CRC between 2008 and 2015 at all designated cancer hospitals in Fukushima Prefecture, Japan, were enrolled in this study. We evaluated the impact of colon perforation on the survival outcomes of patients with metastatic CRC. The main outcome was the adjusted hazard ratio (aHR) of perforation for overall survival (OS). Survival time and HRs were estimated using Kaplan‒Meier and Cox proportional regression analyses. RESULTS A total of 1258 patients were enrolled (perforation: n = 46; non-perforation: n = 1212). All but one of the patients with perforation underwent primary resection or colostomy and 25 cases were able to receive chemotherapy. The median OS for the perforation and non-perforation groups was 19.0 and 20.0 months, respectively (p = 0.96). Moreover, perforation was not an independent prognostic factor (aHR: 0.99; 95% confidence interval: 0.61-1.28). CONCLUSIONS In metastatic CRC, perforation is not necessarily a poor prognostic factor. Patients with perforation who undergo primary tumor resection or colostomy and prompt initiation of systemic chemotherapy might be expected to have a survival time similar to that of patients with non-perforated colon.
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Reference values of lumbar spine range of motion by sex and age based on the assessment of supine trunk lateral bending-A preliminary study. Fukushima J Med Sci 2024; 70:25-33. [PMID: 38123298 PMCID: PMC10867432 DOI: 10.5387/fms.2023-24] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Accepted: 10/30/2023] [Indexed: 12/23/2023] Open
Abstract
[Purpose] The purpose of this study was to clarify the preliminary reference values for the lumbar spine range of motion associated with lateral bending exercises by gender and age group. [Methods] Subjects were 82 volunteers without low back pain, including five males and five females in each age group from 16-19 to 80-89 years. All subjects underwent radiographs of the lumbar spine with lateral flexion; the range of lateral flexion of the vertebrae from T12 to the sacrum (ROLB) was measured twice by three observers. [Results] The ROLB of the entire T12-S1 of all subjects showed a significant negative correlation with age in both sexes (p < 0.01). The ROLB of the lumbar spine tended to be greater in females, with a statistically significant difference between those aged 16-19 and 70-79 (p < 0.05). Lateral flexion angles for each intervertebral segment were largest at L3-L4 and smallest at L5-S1 (0.7°). [Conclusion] Lumbar ROLB reference values were examined by gender and age group; ROLB was greatest in L3-L4, and ROLB tended to be lower in older age groups.
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Preoperative factors affecting the two-year postoperative patient-reported outcome in single-level lumbar grade I degenerative spondylolisthesis. NORTH AMERICAN SPINE SOCIETY JOURNAL 2023; 16:100269. [PMID: 37731461 PMCID: PMC10507637 DOI: 10.1016/j.xnsj.2023.100269] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Revised: 08/16/2023] [Accepted: 08/18/2023] [Indexed: 09/22/2023]
Abstract
Background The choice of operative method for lumbar spinal stenosis with Meyerding grade I degenerative spondylolisthesis remains controversial. The purpose of this study was to identify the preoperative factors affecting the 2-year postoperative patient-reported outcome in Meyerding grade I degenerative spondylolisthesis. Methods Seventy-two consecutive patients who had minimally invasive decompression alone (D group; 28) or with fusion (DF group; 44) were enrolled. The parameters investigated were the Japanese Orthopaedic Association back pain evaluation questionnaire as patient-reported assessment, and L4 slippage (L4S), lumbar lordosis (LL), and lumbar axis sacral distance (LASD) as an index of sagittal alignment for radiological evaluation. Data collected prospectively at 2 years postoperatively were examined by statistical analysis. Results Sixty-two cases (D group; 25, DF group; 37) were finally evaluated. In multiple logistic regression analysis, preoperative L4S and LASD were extracted as significant preoperative factors affecting the 2-year postoperative outcome. Patients with preoperative L4S of 6 mm or more have a lower rate of improvement in lumbar spine dysfunction due to low back pain (risk ratio=0.188, p=.043). Patients with a preoperative LASD of 30 mm or more have a higher rate of improvement in lumbar dysfunction due to low back pain (risk ratio=11.48, p=.021). The results of multiple logistic analysis by operative method showed that there was a higher rate of improvement in lumbar spine dysfunction due to low back pain in patients with preoperative LASD of 30 mm or more in DF group (risk ratio=172.028, p=.01). Conclusions Preoperative L4S and LASD were extracted as significant preoperative factors affecting patient-reported outcomes at 2 years postoperatively. Multiple logistic analyses by the operative method suggested that DF may be advantageous in improving lumbar dysfunction due to low back pain in patients with preoperative LASD of 30 mm or more.
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Clinical Indicators to Determine the Timing of Surgery for Adhesive Small Bowel Obstruction. Am Surg 2023; 89:5768-5774. [PMID: 37159935 DOI: 10.1177/00031348231175465] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/11/2023]
Abstract
BACKGROUND Decompression of the intestine with a long tube or nasogastric tube is the first-choice treatment for adhesive small bowel obstruction (ASBO). Scheduling surgery while weighing the risks of surgery against conservative care is a crucial factor in clinical decision-making. Whenever feasible, unnecessary surgeries should be avoided, and it is essential to provide clinical markers for this. This study aimed to obtain evidence regarding the optimal timing of ASBO and when conservative treatment options are not successful. METHODS The data of patients diagnosed with ASBO and receiving long tube insertion for more than 7 days were reviewed. We investigated transit ileal drainage volume and recurrence. The primary outcomes were the change in the drainage volume from the long tube over time and the percentage of patients who required surgery. We evaluated some cutoff values to determine the indication for surgery based on the insertion duration and volume of long tube drainage. RESULTS Ninety-nine patients were enrolled in this study. Fifty-one patients showed improvement with conservative treatment, whereas 48 ultimately required surgery. When a daily drainage volume of ≥500 mL was considered an indication for surgery, 13-37 cases (25%-72%) would be judged unnecessary within 6 days of long tube insertion, while 5 cases (9.8%) would be judged unnecessary on day 7. DISCUSSION Unnecessary surgical interventions for ASBO might be avoided by assessing the drainage volume on day 7 after inserting a long tube.
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Potential influencing factor on health-related quality of life in Japanese with knee osteoarthritis: the Locomotive syndrome and Health outcome in Aizu cohort Study (LOHAS). J Exp Orthop 2023; 10:88. [PMID: 37633851 PMCID: PMC10460335 DOI: 10.1186/s40634-023-00649-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/04/2023] [Accepted: 07/31/2023] [Indexed: 08/28/2023] Open
Abstract
PURPOSE Several studies have investigated the factors that influence health-related quality of life in patients with knee osteoarthritis (KOA). This study aimed to identify and investigate the degree of involvement of potential factors influencing health-related quality of life (HRQOL) in an aged population with or without KOA. METHODS This multi-centered study included 651 participants who underwent health checkups in rural areas of Japan in 2010. The association between three component summary score of short-form 12 (physical component summary; PCS, mental component summary; MCS, and role-social component summary; RCS) and covariates were investigated using multiple linear regression model and calculated the scaled estimated regression coefficient. RESULTS Decreasing mobility, severity of knee pain, high pain-related self-efficacy (PSE), older age, high functional self-efficacy (FSE), and female gender had significant effect on PCS (p < 0.05). However, radiographic KOA had no influence on PCS. Presence of depression and body mass index had a significant influence on the MCS (p < 0.05). Decreasing mobility, presence of depression, PSE and older age had significant influence on the RCS (p < 0.05). CONCLUSION Our study results showed that physical, mental, and role/social QOL were affected by different influencing factors. Physical QOL was strongly influenced by subjective pain, physical performance, and self-efficacy, whereas radiographic KOA had no such effect. Depressive mood is associated with both mental and role/social QOL. The role/social QOL was predominantly affected by physical function and pain-related self-efficacy. Taking measure to improving functional ability and mental status might be the key factor to improve HRQOL in patient with KOA. LEVEL OF EVIDENCE Level 3: Epidemiologic cross-sectional study (prognostic study).
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Knee locking caused by osteochondroma of the proximal tibia adjacent to the pes anserinus: A case report. World J Clin Cases 2023; 11:5595-5601. [PMID: 37637681 PMCID: PMC10450376 DOI: 10.12998/wjcc.v11.i23.5595] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Revised: 06/27/2023] [Accepted: 07/25/2023] [Indexed: 08/16/2023] Open
Abstract
BACKGROUND Osteochondroma is one of the most common benign bone tumors, and it may cause bone and joint deformities and limited range of motion of an adjacent joint. The pes anserinus region is one of the most frequent sites of osteochondroma, but knee locking caused by osteochondromas in the pes anserinus region is extremely rare. CASE SUMMARY We describe a 13-year-old Japanese girl's extra-articular knee locking that occurred when the semitendinosus tendon got caught in osteochondroma that had developed in the pes anserinus region. The osteochondroma was surgically resected. The postoperative outcome has been excellent, with no recurrence of knee locking or tumor one-year post-surgery. CONCLUSION When a young person develops knee locking, the possibility of extra-articular as well as intra-articular locking should be considered. Osteochondroma, one of the causes of extra-articular locking, can be treated with surgery with good postoperative results.
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Prediction of the prognosis of somatoform disorders using the Minnesota Multiphasic Personality Inventory. Fukushima J Med Sci 2023; 69:105-113. [PMID: 37164766 PMCID: PMC10480515 DOI: 10.5387/fms.2022-04] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Accepted: 03/06/2023] [Indexed: 05/12/2023] Open
Abstract
BACKGROUND Somatoform disorders are frequently resistant to treatment. This study aimed to determine the utility of the Minnesota Multifaceted Personality Inventory (MMPI) in predicting the prognosis of somatoform disorders. METHODS Overall, 125 patients diagnosed with somatoform disorders between January 1, 2013 and December 31, 2017 in the psychiatric department of Fukushima Medical University Hospital were included. Patients with positive outcomes were identified based on a subjective estimation regarding (1) pain and (2) social functions, including activities of daily living. They were divided into the improved group (IG) and the non-improved group (NIG). Each factor was then descriptively compared between the two groups, and the sensitivity and specificity were determined. RESULTS The NIG had significantly higher scores but only on the Hy scale. Thus, the optimal Hy scale cutoff score was calculated. The cutoff point was 73.5, with a sensitivity of 55.7% and a specificity of 71.7%. CONCLUSION An MMPI Hy scale score higher than a cutoff value of 73.5 predicts a poor response to conventional supportive psychotherapy or drug therapy in patients with somatoform disorders. This cutoff point may be used as an important index for selecting treatment for somatoform disorders.
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Voluntary reducible recurrent anterior dislocation of radial head in juvenile baseball player. A case report and review of the literatures. JSES REVIEWS, REPORTS, AND TECHNIQUES 2023; 3:436-442. [PMID: 37588506 PMCID: PMC10426555 DOI: 10.1016/j.xrrt.2023.05.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 08/18/2023]
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Relationship between physical activity and bone mineral density loss after gastrectomy in gastric cancer patients. Support Care Cancer 2022; 31:19. [PMID: 36513863 DOI: 10.1007/s00520-022-07500-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2022] [Accepted: 11/22/2022] [Indexed: 12/15/2022]
Abstract
PURPOSE The prevention of osteoporosis is a particularly relevant issue for gastric cancer survivors. We investigated the relationship between postoperative physical activity and the change of bone mineral density (BMD) in patients with gastric cancer. METHODS Patients who underwent radical gastrectomy for gastric cancer were enrolled in this single-center prospective cohort study. Physical activity was evaluated using the International Physical Activity Questionnaire Short Form at postoperative month (POM) 6 and patients were classified into high, middle, and low physical activity groups accordingly. The primary outcome was the change in BMD from baseline at POM 12, which was expressed as a percentage of the young adult mean (YAM). The YAM of the lumbar spine and femoral neck was measured by dual-energy X-ray absorptiometry. RESULTS One hundred ten patients were enrolled in this study. The physical activity level at POM 6 was classified as high (n = 50; 45%), middle (n = 25; 23%), and low (n = 35; 32%). The mean decrease of YAM% was 5.1% in the lumbar spine and 4.2% in the femoral neck at POM 12. A multivariable-adjusted logistic regression model revealed that low physical activity at POM 6 was a significant risk factor for BMD loss at POM 12 (odds ratio, 3.76; 95% confidence interval, 1.48-9.55; p = 0.005). CONCLUSION Low physical activity after gastrectomy is an independent risk factor for decreased BMD at POM 12. The introduction of exercise may prevent osteoporosis after the surgical treatment of gastric cancer.
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Bow hunter's syndrome: temporary obstruction of blood flow in the affected vertebral artery during posterior occipitocervical fusion. Illustrative case. JOURNAL OF NEUROSURGERY. CASE LESSONS 2022; 4:CASE22428. [PMID: 36681969 PMCID: PMC9745583 DOI: 10.3171/case22428] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Accepted: 10/20/2022] [Indexed: 12/14/2022]
Abstract
BACKGROUND Bow hunter's syndrome (BHS) is a rare condition characterized by mechanical impingement of a vertebral artery (VA) during neck rotation followed by vertebrobasilar insufficiency. Posterior fusion is a typical surgical method for BHS. OBSERVATIONS The case of a 70-year-old Japanese man who presented with presyncope that occurred during right cervical rotation is reported. Given the possibility of vertebrobasilar insufficiency, digital subtraction angiography and computed tomography angiography were performed and showed a hypoplastic right VA and severe stenosis of the left VA over the occiput (O)-C2 level. The blood flow of the left VA was interrupted by right cervical rotation, with resumption of blood flow on left cervical rotation. BHS was diagnosed, and posterior fusion at the O-C2 level was performed. Immediately after implant fixation, selective arteriography confirmed disruption of blood flow in the left VA. The rods were removed immediately; resumption of blood flow was confirmed; and the rods were refixed, anatomically bent with slight left cervical rotation. Then, sustained blood flow in the left VA was confirmed. LESSONS Posterior fixation for BHS can induce VA occlusion due to minor changes in cervical spine alignment. Intraoperative selective arteriography is a necessary tool to identify occlusion of the affected VA.
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Radiological and pathological characteristics of synovial hemangioma of the knee. Exp Ther Med 2022; 25:23. [PMID: 36561614 PMCID: PMC9748666 DOI: 10.3892/etm.2022.11722] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Accepted: 11/04/2022] [Indexed: 11/24/2022] Open
Abstract
Synovial hemangioma, a rare benign tumor that occurs most frequently in the knee in children and young adults, has four histological subtypes: Venous, arteriovenous, cavernous and capillary hemangiomas. Since the clinical presentation and radiological findings of synovial hemangioma are non-specific, there is frequently a long period between the onset and the diagnosis. The cases of nine patients, pathologically diagnosed with synovial hemangioma and surgically treated, were retrospectively analyzed. All nine patients had persistent knee pain. In addition, three patients also had a swollen knee with intra-articular hemorrhage. Plain radiography revealed intra-articular phleboliths in two patients. In seven patients, T1-weighted magnetic resonance imaging showed low signal intensity with small signal voids. On T2-weighted imaging, all patients showed high signal intensity containing small signal voids. All patients underwent surgical excision; there was no postoperative recurrence after the final operation, and the knee pain had disappeared at the final follow-up. From the pathological findings, the diagnoses were venous hemangioma, cavernous hemangioma and capillary hemangioma (three patients each).
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Clinical Benefit of Polypectomy With Cutting Current for Colorectal Polyps: A Randomized Controlled Trial. Anticancer Res 2022; 42:3613-3619. [PMID: 35790298 DOI: 10.21873/anticanres.15849] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Revised: 05/20/2022] [Accepted: 05/24/2022] [Indexed: 11/10/2022]
Abstract
BACKGROUND/AIM This study aimed to examine the effectiveness of polypectomy with cutting current (PCC) for colorectal polyps, compared with cold snare polypectomy (CSP). PATIENTS AND METHODS The study design was a singlecenter randomized controlled trial. We included patients with one or more non-pedunculated colorectal polyps of 6 mm or more and less than 10 mm. The primary endpoint was the proportion of complete resection of the muscularis mucosae. RESULTS Twenty-seven patients (37 polyps) were assigned to the CSP group, and 22 (29 polyps) were assigned to the PCC group. The number of polyps that could achieve complete muscularis mucosae resection was 7 (20.0%) in the CSP group and 24 (92.3%) in the PCC group, and the rate of complete muscularis mucosae resection was statistically significantly higher in the PCC group. CONCLUSION PCC is a safer procedure because it can remove the muscularis mucosae more reliably.
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Efficacy of duloxetine in patients with knee osteoarthritis or chronic low back pain with early pain reduction: An exploratory post-hoc analysis of Japanese phase 3, 1-year extension studies. J Orthop Sci 2022; 27:717-724. [PMID: 33958268 DOI: 10.1016/j.jos.2021.02.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2020] [Revised: 02/22/2021] [Accepted: 02/28/2021] [Indexed: 11/16/2022]
Abstract
BACKGROUND Two previous phase 3, double-blind, randomized, placebo-controlled trials showed that duloxetine 60 mg/day for 14 weeks significantly improved pain and quality of life in Japanese patients with knee osteoarthritis or chronic low back pain. In their open-label extension studies, these improvements were maintained for ≥48 weeks. This post-hoc analysis assessed the relationship between initial response to duloxetine and long-term pain reduction and quality of life in patients with knee osteoarthritis or chronic low back pain. METHODS Patients (knee osteoarthritis: N = 43; chronic low back pain: N = 41) were subdivided based on extent of pain reduction from baseline to Week 4 of duloxetine (≥30%, 10-30%, or <10% reduction in Brief Pain Inventory-Severity average pain score). Outcome measures were changes from baseline for Brief Pain Inventory-Severity and Brief Pain Inventory-Interference at regular intervals up to Week 65. RESULTS Mean change from baseline in Brief Pain Inventory-Severity was greater in patients with ≥30% early pain reduction than in patients with <10% early pain reduction through Week 27 for both conditions, and also Weeks 47-65 for back pain. Compared with the <10% early pain reduction group, mean change from baseline in the average of seven Brief Pain Inventory-Interference domain scores was greater in the ≥30% or 10-30% early pain reduction groups for knee osteoarthritis (except Weeks 63-65), and in the ≥30% early pain reduction group for chronic low back pain through Week 19. CONCLUSIONS These results suggest that patients with knee osteoarthritis who respond well to duloxetine in the first month might experience sustained, long-term pain relief with generally greater quality-of-life improvement than patients with poor initial response. Patients with chronic low back pain who had strong initial response may experience a greater long-term pain relief, but not greater quality-of-life improvement, than patients with poor initial response.
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Impact of histological subtype on prognosis in stage IV colorectal cancer: A population-based cohort study. PLoS One 2022; 17:e0264652. [PMID: 35239725 PMCID: PMC8893698 DOI: 10.1371/journal.pone.0264652] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Accepted: 02/14/2022] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND There are a few established prognostic factors for stage IV colorectal cancer. Thus, this study aimed to evaluate the impact of histological subtypes on prognosis and metastatic patterns in patients with stage IV colorectal cancer. METHODS This was a population-based, multicenter, cohort study. We included consecutive patients diagnosed with stage IV colorectal cancer between 2008 and 2015 at all designated cancer hospitals in Fukushima prefecture, Japan. Patients were classified into two groups according to histological subtypes as follows: poorly differentiated adenocarcinoma (Por), mucinous adenocarcinoma (Muc), or signet-ring cell carcinoma (Sig) and well (Wel) or moderately differentiated adenocarcinoma (Mod). We evaluated the relationship between these histological groups and survival time. After adjusting for other clinical factors, we calculated the hazard ratio for Por/Muc/Sig. RESULTS A total of 1,151 patients were enrolled, and 1,031 and 120 had Wel/Mod and Por/Muc/Sig, respectively. The median overall survival was 19.2 and 11.9 months for Wel/Mod and Por/Muc/Sig, respectively (p < 0.001). The adjusted hazard ratio for Por/Muc/Sig with regard to survival time was 1.42 (95% confidence interval: 1.13-1.77). Por/Muc/Sig had a lower incidence of liver and lung metastases and a higher incidence of peritoneal dissemination and metastasis to rare organs, such as the bone and brain. CONCLUSIONS The Por/Muc/Sig histological subtype was an independent prognostic factor for poor prognosis among patients with stage IV colorectal cancer. The histological subtype may be useful for predicting the prognosis of patients with stage IV colorectal cancer and designing the treatment strategy.
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Surgical treatment for a combined anterior cruciate ligament and posterior cruciate ligament avulsion fracture: A case report. World J Clin Cases 2022; 10:3879-3885. [PMID: 35647157 PMCID: PMC9100726 DOI: 10.12998/wjcc.v10.i12.3879] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2021] [Revised: 01/11/2022] [Accepted: 03/06/2022] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Independent avulsion fractures with anterior cruciate ligament (ACL) or posterior cruciate ligament (PCL) attachment are relatively common among tibial intercondylar eminence fractures, and their postoperative outcomes are generally favorable. Conversely, huge avulsion fractures of the intercondylar eminence containing the attachment site of both the ACL and the PCL are extremely rare, and the reported clinical outcomes are poor.
CASE SUMMARY We describe a 30-year-old Japanese male's huge avulsion fracture of the intercondylar eminence of a tibia containing the attachment site of both the ACL and PCL, together with a complete tear of the medial collateral ligament and a partial tear of both the medial and lateral menisci caused by a fall from a high place. All of these injuries were treated surgically, with anatomical reduction and stable fixation. The limb function at 1 year post-surgery was excellent (Lysholm score: 100 points).
CONCLUSION Although this patient's complete surgical repair was complex, it should be performed in similar cases for an excellent final clinical outcome.
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The role of the flexor pronator muscles as dynamic stabilizers against elbow valgus stress in patients with medial ulnar collateral ligament insufficiency. J Shoulder Elbow Surg 2022; 31:694-698. [PMID: 34767963 DOI: 10.1016/j.jse.2021.10.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2021] [Revised: 09/30/2021] [Accepted: 10/11/2021] [Indexed: 02/01/2023]
Abstract
BACKGROUND The flexor pronator muscles (FPMs) have been reported to act as dynamic stabilizers against valgus forces in overhead-throwing athletes. Several studies have demonstrated the anatomic, biomechanical, and clinical effects of the FPMs. However, no studies have investigated the in vivo kinematics of the FPMs against the valgus forces on the elbow. This study aimed to clarify the clinical contribution of the FPMs as dynamic stabilizers in medial ulnar collateral ligament (MUCL) insufficiency. METHODS Eighteen baseball players with MUCL injury participated in this study. The elbow was flexed to 90°, and the forearm was placed in the supinated position. Manual valgus stress was applied to the elbow joint until maximal shoulder external rotation was achieved. The width of the ulnohumeral joint space was measured using ultrasonography, and any changes in medial elbow pain were recorded before and after isometric forearm pronation. RESULTS All the subjects had MUCL tenderness and felt medial elbow pain when elbow valgus stress was applied. The width of the medial joint space was significantly larger on the injured side than on the healthy side (5.1 ± 1.0 mm vs. 3.2 ± 1.0 mm) with elbow valgus stress. During isometric forearm pronation, the width of the medial joint space was significantly decreased (3.1 ± 0.9 mm vs. 2.6 ± 1.0 mm) and medial elbow pain had completely diminished. CONCLUSION Isometric forearm pronation reduces valgus stress-induced widening of the medial joint space and medial elbow pain in patients with MUCL insufficiency.
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The Influence of Chronic Medial Epicondylar Apophysitis on Medial Ulnar Collateral Ligament Insufficiency - Retrospective Cohort Study. JSES Int 2022; 6:539-544. [PMID: 35572434 PMCID: PMC9091731 DOI: 10.1016/j.jseint.2021.12.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Background This study aimed to investigate the effect of chronic traction apophysitis of the medial epicondyle (MEC) on medial ulnar collateral ligament (MUCL) insufficiency in high school baseball players. Methods In this retrospective cohort study, 3034 of 6069 high school baseball players were enrolled. A self-reported questionnaire was distributed to investigate past history of elbow pain and elbow pain during the previous season. Physical examinations to assess tenderness on the MUCL and the elbow valgus stress test (EVST) were performed. Ultrasonography was performed to determine the presence of morphological abnormalities of the anteroinferior aspect of the MEC (MEC lesions). Results Participants with MEC lesions had a significantly higher prevalence of past history of elbow pain, elbow pain during the previous season, MUCL tenderness, and positive EVST than those without MEC lesions (P < .05). Multivariate logistic regression analysis revealed that the participants with the fragmented type had the highest risk of past history of elbow pain (odds ratio [OR] = 3.94), elbow pain during the previous season (OR = 2.27), positive EVST (OR = 3.49), and the second highest risk of MUCL tenderness (OR = 2.01) followed by the irregular type (OR = 2.31). Participants with the hypertrophic type had the lowest risk of past history of elbow pain (OR = 2.08), elbow pain during the previous season (OR = 1.42), MUCL tenderness (OR = 1.09), and positive EVST (OR = 1.47). Conclusion The presence of chronic non-healed traction apophysitis of the MEC in high school baseball players presented a significantly high risk of elbow pain and MUCL insufficiency.
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Clinical Impact of Primary Tumor Site in Stage IV Colorectal Cancer: A Statewide Cohort Study. Anticancer Res 2021; 41:5693-5702. [PMID: 34732442 DOI: 10.21873/anticanres.15385] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Revised: 09/07/2021] [Accepted: 09/23/2021] [Indexed: 11/10/2022]
Abstract
BACKGROUND/AIM We investigated the clinical impact of the primary tumor site in stage IV colorectal cancer (CRC). PATIENTS AND METHODS In this statewide multicenter retrospective cohort, patients with stage IV CRC from nine hospital-based cancer registries across the Fukushima Prefecture (2008-2015) were categorized based on three primary tumor sites: right colon cancer (RCC), left colon cancer (LCC), and rectal cancer. Overall survival was assessed using Cox regression analysis. RESULTS A total of 1,211 patients were included. The most common clinical symptom was obstruction in LCC and bleeding in rectal cancer. Liver metastases were multiple and larger in LCC, while lung metastases were multiple in rectal cancer. Compared to LCC, the adjusted hazard ratio (HR) for overall survival was 1.19 [95% confidence interval (CI)=1.01-1.39, p=0.032] in RCC and 1.03 (95% CI=0.86-1.23, p=0.77) in rectal cancer. CONCLUSION RCC was independently associated with a worse prognosis in stage IV CRC.
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Association of high serum soluble interleukin 2 receptor levels with risk of adverse events in patients with cardiac sarcoidosis. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.1797] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Abstract
Background
Sarcoidosis is a systemic granulomatous disease that affects multiple organs. Among these, the presence of cardiac involvement is recognised as a determinant of worse clinical outcomes. Soluble interleukin 2 receptor (sIL-2R) is a potentially useful biomarker in the diagnosis and evaluation of disease severity in patients with sarcoidosis. However, it remains to be seen whether sIL-2R is associated with the severity and activity of disease in patients with cardiac sarcoidosis (CS).
Purpose
The aims of this study were to investigate whether sIL-2R was associated with clinical outcomes and to clarify the relationship between sIL-2R levels and disease activity evaluated by 18F-fluorideoxyglucose in positron emission tomography/computed tomography (18F-FDG PET/CT) in patients with CS.
Methods
We examined 101 consecutive patients with CS who were admitted to our University HospitalbetweenMay 2003 and February 2020. Patients who had no data of serum sIL-2R levels before initiation of immunosuppressive therapy (n=18) were excluded. Ultimately, 83 patients were examined in this study. The primary outcome was a composite of advanced atrioventricular block (AVB), ventricular tachycardia or ventricular fibrillation (VT/VF), heart failure hospitalisation, and all-cause death. Inflammatory activity in the myocardium and lymph nodes were assessed by18F-FDG PET/CT. We used a published program to analyse the cardiac metabolic activity (CMA), and total lymph node glycolysis (TLyG), which are quantitative measures of FDG volume-intensity.
Results
During a median follow-up period of 2.96 (interquartile range 2.24–4.27) years, the primary outcome occurred in 24 patients (29%), including 1 advanced AVB, 13 VT/VF, 5 hospitalisations for heart failure, and 5 all-cause deaths. Kaplan-Meier analyses showed that the primary outcome occurred more frequently in patients with higher sIL-2R levels (>538 U/mL, the median) than in those with lower sIL-2R levels (Figure). A multivariable Cox regression analysis revealed that a higher sIL-2R level was independently associated with an increased subsequent risk of adverse events (hazard ratio 3.71, 95% confidence interval 1.63–8.44, p=0.002), even after adjustments for age, plasma B-type natriuretic peptide, estimated glomerular filtration rate, left ventricular ejection fraction, and late gadolinium enhancement, which are known to be strong determinants of worse clinical outcomes in patients with CS (Table). Furthermore, sIL-2R levels were significantly correlated with TLyG, the inflammatory activity in lymph nodes (r=0.346, p=0.003) but not with CMA, the inflammatory activity in myocardium (r=0.131, p=0.27).
Conclusions
Increased sIL-2R is associated with worse long-term clinical outcomes accompanied by increased systemic inflammatory activity in CS patients. These findings suggest the importance of assessing sIL-2R as a surrogate marker for further risk stratification in these patients.
Funding Acknowledgement
Type of funding sources: Public Institution(s). Main funding source(s): Japan Society for the Promotion of Science
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Corneal Eccentricity in a Rural Japanese Population: The Locomotive Syndrome and Health Outcome in Aizu Cohort Study (LOHAS). Ophthalmic Epidemiol 2021; 29:531-536. [PMID: 34427161 DOI: 10.1080/09286586.2021.1968004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
PURPOSE To determine normal corneal eccentricity in a rural Japanese population and to examine factors associated with eccentricity value. METHODS This used data from the Locomotive Syndrome and Health Outcome in Aizu Cohort Study (LOHAS) project between 2009 and 2012. Residents of Minamiaizu and Tadami in Fukushima, Japan, who were aged 40 years or over, were invited for a comprehensive eye examination. For 1371 patients with no history of internal eye surgery, corneal eccentricity was measured using a Pentacam. RESULTS Of 1371 people recruited to the study, 1215 (1215 eyes) met the inclusion criteria. The overall mean eccentricity was 0.46 (SD = 0.18; range, -0.85 to 0.88). Corneal eccentricity was significantly associated with age, spherical equivalent, pupil diameter, anterior chamber angle, anterior chamber volume, and central corneal thickness, but not with gender or body mass index. CONCLUSIONS In this study, the normal cornea in this Japanese population was prolate. Corneal eccentricity was likely to decrease with increasing age. Also, spherical equivalent and other anterior segment parameters had an influence on corneal eccentricity. Corneal eccentricity measurements might be helpful in the diagnosis of corneal diseases and in calculations for intraocular lens implantation and corneal refractive surgery.
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Prevalence and factors associated with uncorrected presbyopia in a rural population of Japan: the Locomotive Syndrome and Health Outcome in Aizu Cohort Study. Jpn J Ophthalmol 2021; 65:724-730. [PMID: 34374906 DOI: 10.1007/s10384-021-00863-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Accepted: 06/22/2021] [Indexed: 10/20/2022]
Abstract
PURPOSE To investigate the prevalence and factors associated with uncorrected presbyopia among rural community dwellers in Japan. STUDY DESIGN A population-based cross-sectional study was conducted in 2011 among community dwellers aged 40-74 years who received specific health checkups in Minamiaizu and Tadami, Fukushima Prefecture, Japan. METHODS Uncorrected presbyopia was considered as when the distance-corrected visual acuity in the better eye was ≥0.5 and the near-presenting visual acuity in the better eye was <0.4, regardless of distance refractive status. Multiple logistic regression analysis was employed to calculate the odds ratios (ORs) for uncorrected presbyopia and to adjust for possible confounders. RESULTS A total of 2054 individuals participated in the specific health checkups. In the 1156 individuals (response rate: 56.28%) analyzed in the study, the mean (SD) age was 63.0 (8.7) years, the percentage of women was higher (57.87%), and the prevalence of uncorrected presbyopia was 26.38% (95% CI 23.86%-29.03%). Multivariate analysis revealed that the factors associated with uncorrected presbyopia were older age (adjusted OR: 1.054 [95% CI: 1.034-1.075]), female sex (adjusted OR: 1.388 [95% CI: 1.006-1.915]), and distance-presenting vision impairment (adjusted OR: 2.651 [95% CI: 1.697-4.143]). CONCLUSION Approximately one-quarter of the participants in this study from a rural population of Japan did not have adequate near vision. It is recommended that a public health intervention should be enacted to correct presbyopia, especially in the older age group, women, and those with uncorrected refractive errors.
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Exponential correlations among neuropathic components, pain intensity, and catastrophic thoughts in patients with musculoskeletal pain disorder. Curr Med Res Opin 2021; 37:1341-1348. [PMID: 33978548 DOI: 10.1080/03007995.2021.1929137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
BACKGROUND Neuropathic components and catastrophic thoughts contribute to the quality of life impairments in patients with chronic pain. This retrospective cross-sectional observational study examined the extent to which neuropathic components affect pain intensity and catastrophic thoughts using a mathematical model. METHODS Participants with chronic pain with spinal or joint disorders were rated for pain intensity using a numerical rating scale (NRS), painDETECT questionnaire (PDQ), and pain catastrophizing scale (PCS). We plotted to scatter plots between PDQ and either NRS or PCS and drew best-fit lines for patients with leg pain only. We divided patients with both leg and back pain into two clusters: located above or below the baselines, and then we drew the best-fit lines for each cluster. We performed factor analysis on PDQ items and developed and validated a discriminant to identify patients located above the baseline in another cohort of musculoskeletal disorders. RESULTS We analyzed 163 patients with lumbar disorders and 205 patients with joint disorders. PDQ correlated exponentially with NRS and PCS of the patients located above the baseline in both disorder groups and correlated linearly or logarithmically in patients located below the baseline. Factor analysis revealed three sets of pain characteristics for each disorder. We developed the discriminant from PDQ items to identify patients showing exponential correlations and then validated it in another cohort of 137 patients. The coefficient for "pressure-evoked pain" was the highest in the discriminant. CONCLUSIONS Mathematical models indicate neuropathic components demonstrate linear correlations with NRS and PCS generally, but exponential correlations in a cluster of the patients with musculoskeletal pain. We developed and validated the discriminant based on pain characteristics to identify such patients; "pressure-evoked pain" was the most significant contributor.
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Visualization of hidden soft-tissue recurrence of giant cell tumor of bone enabled by preoperative denosumab treatment: a case description. Quant Imaging Med Surg 2021; 11:3893-3897. [PMID: 34341758 DOI: 10.21037/qims-20-1157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Accepted: 02/17/2021] [Indexed: 11/06/2022]
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Association of Lumbar Spinal Stenosis with Severe Disability and Mortality Among Community-Dwelling Older Adults: The Locomotive Syndrome and Health Outcomes in the Aizu Cohort Study. Spine (Phila Pa 1976) 2021; 46:E784-E790. [PMID: 33394983 DOI: 10.1097/brs.0000000000003912] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
STUDY DESIGN This prospective cohort study analyzed data from the Locomotive Syndrome and Health Outcomes in the Aizu Cohort Study. OBJECTIVE To investigate the association between lumbar spinal stenosis (LSS) and severe disability and mortality among community-dwelling older adults. SUMMARY OF BACKGROUND DATA Only a few studies have investigated LSS longitudinally, and the study participants were limited to selected patients diagnosed with LSS during a hospital visit. Additionally, the prognosis of LSS remains unclear. METHODS We enrolled independent community-dwelling older adults aged 65 years or older at the time of a baseline health checkup in 2008. LSS was diagnosed using a validated diagnostic support tool for LSS. The primary endpoint was a composite of severe disability (long-term care insurance certification grade 4 or 5) and mortality. We used 1 minus Kaplan-Meier failure estimates and the log-rank test to compare the interval between baseline and the predetermined endpoint as well as a Cox proportional hazards model to estimate hazard ratios (HRs) for the LSS group with adjustment for possible confounders. Multiple imputation by chained equations was performed for sensitivity analysis. RESULTS Of 2058 subjects enrolled, 1560 did not have missing covariates; 269 (17%) were diagnosed with LSS. After a median follow-up of 5.8 years, the rates of severe disability and mortality were 0.022 per year in subjects with LSS and 0.012 per year in those without (P = 0.006). The adjusted HR for the composite endpoint in the LSS group was 1.55 (95% confidence interval [CI], 1.01-2.38). A similar association was observed after multiple imputation of missing covariates (adjusted HR, 1.51 [95% CI, 1.06-2.16]). CONCLUSION LSS was associated with severe disability and mortality in community-dwelling older adults. Detection of adults with LSS in the community may contribute to local health promotion.Level of Evidence: 2.
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On the road to ITER NBIs: SPIDER improvement after first operation and MITICA construction progress. FUSION ENGINEERING AND DESIGN 2021. [DOI: 10.1016/j.fusengdes.2021.112622] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Periprosthetic Fracture Resembling Atypical Femoral Fracture After Fixation With Retrograde Intramedullary Nail in Elderly Women: A Report of Two Cases. In Vivo 2021; 35:1837-1842. [PMID: 33910870 DOI: 10.21873/invivo.12445] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Revised: 03/26/2021] [Accepted: 03/29/2021] [Indexed: 11/10/2022]
Abstract
BACKGROUND/AIM The number of individuals diagnosed with and requiring medical treatment for osteoporosis continues to increase due to global population aging and the high awareness of osteoporosis. Bone-modifying agents (BMAs) including bisphosphonate and denosumab are widely used for osteoporosis, and atypical femoral fracture (AFF) is also gaining attention as a severe potential side effect of long-term BMA treatment. The definition of AFF excludes periprosthetic femoral fracture; here, we describe two cases of a periprosthetic femoral fracture that resembled AFF. CASE REPORT The fractures occurred at the proximal tip of the retrograde femoral nail after an internal fixation for a distal femoral shaft fracture in elderly Japanese women. Each woman had been treated with bisphosphonate therapy for >2 years and had continued the bisphosphonate after undergoing surgery for a distal femoral shaft fracture. Each patient had noticed thigh pain before falling down, and plain radiographs showed a short oblique or transverse fracture with medial spike and localized periosteal reaction of the lateral cortex in each case. The fractures were re-fixed with an antegrade intramedullary nail, and bone union was achieved at >1 year after the second operation. Although these two cases were classified as periprosthetic fractures, they fulfilled the characteristics of AFF. CONCLUSION Physicians should conduct a thorough interview of patients with a history of BMA treatment in order to correctly diagnose periprosthetic fractures that resemble AFFs, and they should be aware that symptomatic fractures can be prevented by prophylactic fixation. The discontinuance of BMA therapy and the introduction of another drug such as teriparatide may lead to faster healing of surgically treated AFFs.
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Arthroscopic Elbow Debridement Using Anterocentral Transbrachialis Portal. Arthrosc Tech 2021; 10:e1425-e1430. [PMID: 34258186 PMCID: PMC8252852 DOI: 10.1016/j.eats.2021.02.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2020] [Accepted: 02/07/2021] [Indexed: 02/03/2023] Open
Abstract
Arthroscopic debridement for elbow osteoarthritis has been widely used as a minimally invasive treatment; however, in some cases, it can be a technically demanding procedure, such as in patients with severe osteoarthritis with large spur formation and severe synovitis. The anterocentral transbrachialis portal is a recently developed portal for elbow arthroscopy, which allows easy and convenient access to the anterior compartment for sufficient debridement. This report describes in detail the anterocentral transbrachialis portal and its usefulness for debridement of the elbow joint in osteoarthritis.
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Comparison of ethanol concentrations after drinking in patients who underwent total gastrectomy versus healthy controls. ANZ J Surg 2021; 91:E474-E478. [PMID: 33876538 DOI: 10.1111/ans.16691] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2020] [Revised: 01/26/2021] [Accepted: 02/10/2021] [Indexed: 11/28/2022]
Abstract
BACKGROUND The safety of drinking in patients who have undergone total gastrectomy for gastric cancer has not been established. We conducted a clinical trial to investigate the trend in alcohol absorption in actual patients. METHODS Patients who received total gastrectomy with lymph-node dissection and Roux-en-Y reconstruction six or more months ago were enrolled. Participants drank 1 unit (20 g) of ethanol within 1 h starting at least 1 h after a meal. The blood alcohol concentration (BAC) was then estimated by a measurement of the breath alcohol concentration. The peak and trend in the BAC in patients was compared with that in healthy volunteers who were matched with patients for the alcohol-sensitive genotype. RESULTS Ten patients and 10 healthy people were enrolled in the BAC evaluation. The peak BAC (%) was 0.158 in patients after total gastrectomy versus 0.110 in control (P < 0.001). The mean half-life of BAC was 58.0 min in the patient group and 94.0 min in the control group, although the mean time to complete drinking was significantly longer in the patient group than in the control group at 40.8 versus 21.9 min (P = 0.009). CONCLUSION Drinking alcohol is likely to carry a risk of increasing the BAC in patients who have undergone total gastrectomy.
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Efficacy of duloxetine for multisite pain in patients with knee pain due to osteoarthritis: An exploratory post hoc analysis of a Japanese phase 3 randomized study. J Orthop Sci 2021; 26:141-148. [PMID: 32245696 DOI: 10.1016/j.jos.2020.02.013] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2019] [Revised: 02/20/2020] [Accepted: 02/29/2020] [Indexed: 11/18/2022]
Abstract
BACKGROUND Central sensitization, including dysfunction of descending inhibitory pain pathways, may contribute to multisite pain in patients with chronic musculoskeletal conditions. Duloxetine is a centrally acting analgesic that effectively reduces pain in patients with knee osteoarthritis. Here we assessed the efficacy of duloxetine (60 mg/day) in Japanese patients (N = 353) with pain due to knee osteoarthritis based on the number of painful body sites, determined using the Michigan Body Map. METHODS Post hoc analysis of a phase 3, randomized, placebo-controlled trial (ClinicalTrials.gov; NCT02248480). RESULTS At Week 14, the change from baseline in Brief Pain Inventory-Severity average pain score ("pain reduction") was significantly greater with duloxetine compared with placebo in patients with 3, 4, or ≥5 painful sites, but not in patients with 1 or 2 painful sites. In patients with ≥3 painful sites (57% of patients), pain reduction was significantly greater with duloxetine (n = 100) compared with placebo (n = 101) throughout the study (least squares mean change from baseline to Week 14: -2.68 vs -1.68). Greater pain reduction with duloxetine (n = 77) than placebo (n = 75) also occurred in patients with ≤2 painful sites, although the between-group difference was significant only at Week 4. CONCLUSIONS These results are consistent with duloxetine enhancing the activity of descending inhibitory pain pathways that are dysfunctional in patients with central sensitization and multisite pain. In addition, these results suggest that duloxetine may be an effective choice of analgesic for patients with knee osteoarthritis and multisite pain.
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Overtime is associated with increased cardio-metabolic risks possibly preceding endothelial damage: Miyagi Karoshi prevention study for teachers. Atherosclerosis 2020. [DOI: 10.1016/j.atherosclerosis.2020.10.351] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Magnetic resonance imaging findings in the hyperacute phase of atypical femoral fracture: a case description. Quant Imaging Med Surg 2020; 10:2366-2369. [PMID: 33269232 DOI: 10.21037/qims-20-794] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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Cryptic species in a Vulnerable seabird: shorttailed albatross consists of two species. ENDANGER SPECIES RES 2020. [DOI: 10.3354/esr01078] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
The occurrence of cryptic species within a threatened taxon is rare, but where they do occur, understanding species boundaries is essential for planning an effective conservation strategy. The short-tailed albatross Phoebastria albatrus is a Vulnerable seabird that mainly breeds on Torishima and the Senkaku Islands in the western North Pacific. Although it has been tacitly regarded as a single management unit with 2 breeding sites, the species is known to comprise 2 genetically separated populations (Senkaku-type and Torishima-type). However, morphological examination of birds from both populations has not been conducted owing to the difficulty in accessing the Senkaku Islands. In this study, we examined the morphological differences between immigrants from the Senkaku Islands to Torishima (Senkaku-type) and native birds on Torishima (Torishima-type) and found significant differences in morphological characteristics between the 2 bird types. In general, Torishima-type birds were larger than Senkaku-type birds, whereas Senkaku-type birds had relatively longer beaks. Based on the morphological differences found in this study as well as genetic and ecological differences revealed in previous studies, we believe that Senkaku- and Torishima-type birds should be classified as different cryptic species. To the best of our knowledge, this is the first case of cryptic species being identified in a threatened avian species.
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Salvage Reconstruction With the Masquelet Technique Following Wide Resection for Chondrosarcoma of the Proximal Femoral Metaphysis: A Case Report. In Vivo 2020; 34:3495-3501. [PMID: 33144459 DOI: 10.21873/invivo.12190] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Revised: 08/04/2020] [Accepted: 08/05/2020] [Indexed: 11/10/2022]
Abstract
BACKGROUND Bone reconstruction following a wide resection for a malignant musculoskeletal tumor remains challenging, especially for an intercalary defect following the resection of a metaphyseal lesion. CASE REPORT Here, we describe a surgical procedure using the Masquelet technique for the biological reconstruction of a huge subtrochanteric bone defect following failed pasteurized autologous bone grafting for a conventional chondrosarcoma of the proximal femoral metaphysis with a subtrochanteric pathological fracture. The patient, a 43-year-old Japanese male, was able to walk without a cane or a brace at 15 months after the final operation (International Society of Limb Salvage score, 86.7%). CONCLUSION This procedure should be considered as one of the reconstruction options following the wide resection of malignant bone tumors located in the metaphysis.
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Abstract
RATIONALE Osteosarcoma is the most common primary malignant bone tumor in children. The prognosis of osteosarcoma has improved with the use of aggressive systemic chemotherapy in addition to surgery. The relapse of osteosarcomas is usually as lung metastasis observed within 2 to 3 years after the initial treatment. A relapse is rarely observed at >10 years. PATIENT CONCERNS We report the case of a 51-year-old Japanese man who was treated for high-grade osteosarcoma of the femur at 13 years old. He was referred to our hospital with a suspicion of primary lung cancer based on back pain, respiratory distress, and an abnormal mass on chest radiograph. DIAGNOSES Computed tomography-guided biopsy confirmed the lung lesion as a metastatic recurrence of high-grade osteosarcoma without local recurrence. INTERVENTIONS Chemotherapy was planned, but the patient's general condition rapidly deteriorated and thus palliative therapy was provided. OUTCOMES The patient died 2 months after the initial consultation. LESSONS The survival durations of osteosarcoma patients have been prolonged by recent progress in multimodality therapy, and thus clinicians as well as osteosarcoma patients should always keep in mind the possibility of very late relapse.
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P2.03-53 Immunoproteasome as a Potential Therapeutic Target in Cisplatin-Resistant Small and Non-Small Cell Lung Cancer. J Thorac Oncol 2019. [DOI: 10.1016/j.jtho.2019.08.1500] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Impaired Extension of the Digits due to Bilateral Idiopathic Intrinsic Contracture: A Case Report. J Hand Surg Asian Pac Vol 2019; 24:383-385. [PMID: 31438786 DOI: 10.1142/s2424835519720160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Idiopathic intrinsic contracture (IIC) with no history of trauma, ischemia, or spasticity is extremely rare. We report herein a case of impaired extension of the digits due to bilateral IICs occurred in a 30-year-old woman with a past medical history of eating disorder and amenorrhea. Although no previous case has been reported in the literature, eight similar cases of IIC have been presented at Japanese domestic conferences. In these eight cases and the present case, resection of the thenar muscle cords and unilateral resection of the lateral band were effective. Since IIC in patients with an eating disorder is a rare condition, it would be treated conservatively at first as tendon sheath inflammation or locking. However, this condition may be resistant to conservative treatment, and surgical treatment should be considered in such cases.
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Safety of tapering tacrolimus dose in patients with well-controlled anti-acetylcholine receptor antibody-positive myasthenia gravis. Eur J Neurol 2019; 27:100-104. [PMID: 31309642 DOI: 10.1111/ene.14039] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2019] [Accepted: 07/10/2019] [Indexed: 01/09/2023]
Abstract
BACKGROUND AND PURPOSE Tapering immunosuppressants is desirable in patients with well-controlled myasthenia gravis (MG). However, the association between tapering of calcineurin inhibitor dosage and reduction-associated exacerbation is not known. The aim of this study was to clarify the frequency of reduction-associated exacerbation when tacrolimus is tapered in stable patients with anti-acetylcholine receptor antibody-positive MG, and to determine the factors that predict exacerbations. METHODS We retrospectively analyzed 115 patients in whom tacrolimus dosage was tapered. The reduction-associated exacerbation was defined as the appearance or worsening of one or more MG symptoms <3 months after the reduction. RESULTS Tacrolimus dosage was successfully tapered in 110 patients (96%) without any exacerbation. Five patients (4%) experienced an exacerbation, but symptoms were reversed in all patients when the tacrolimus dose was increased to the previous maintenance level. No patient developed an MG crisis. The age at onset was significantly earlier (30 vs. 56 years, P = 0.025) and the reduction in dosage was significantly larger (2.0 vs. 1.0 mg/day, P = 0.002) in patients with reduction-associated exacerbation than in those without exacerbation. The cut-off values determined in a receiver-operating characteristic curve analysis were 52 years (sensitivity, 57%; specificity, 100%) for the age at onset and 1.5 mg (sensitivity, 80%; specificity, 100%) for the dose reduction. CONCLUSION Tapering of tacrolimus was possible in most patients with well-controlled anti-acetylcholine receptor antibody-positive MG. Early age at onset and a large reduction from maintenance dosage were associated with exacerbation. Reductions ≤1.5 mg/day from the maintenance dosage should be considered for patients with late-onset disease.
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Acute pseudogout lumbar discitis resembling acute pyelonephritis in an elderly woman. Intern Med J 2019; 49:1048-1050. [PMID: 31387154 DOI: 10.1111/imj.14390] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2018] [Revised: 10/14/2018] [Accepted: 10/20/2018] [Indexed: 11/27/2022]
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Sufficient duration of off-season decreases elbow disorders in elementary school-aged baseball players. J Shoulder Elbow Surg 2019; 28:1098-1103. [PMID: 31003885 DOI: 10.1016/j.jse.2019.02.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2018] [Revised: 02/04/2019] [Accepted: 02/15/2019] [Indexed: 02/01/2023]
Abstract
BACKGROUND Several guidelines for the prevention of throwing injuries recommend a sufficiently long off-season; however, few studies providing scientific evidence to support these recommendations exist. Our study aimed to clarify the association between off-season duration and throwing elbow injuries among elementary school-aged baseball players. METHODS This study enrolled 680 elementary school-aged baseball players who underwent medical checkups. The experience with elbow pain and the off-season duration were investigated via the administration of a self-completed questionnaire. Ultrasonographic assessment of the elbow joint was performed on the day of the medical checkup to assess for morphologic abnormalities. RESULTS The prevalence of elbow pain and morphologic abnormalities of the medial epicondyle (medial epicondyle lesions) was significantly decreased when the subjects' off-season duration was longer. Multivariate analysis revealed that the risk of elbow pain was significantly lower in the group whose off-season lasted 1 to 2 months (odds ratio [OR], 0.32; 95% confidence interval [CI], 0.15-0.62; P = .0006) and in the group whose off-season lasted longer than 2 months (OR, 0.59; 95% CI, 0.37-0.95; P = .0316). The risk of medial epicondyle lesions was also significantly lower in the group whose off-season lasted 1 to 2 months (OR, 0.39; 95% CI, 0.22-0.67; P = .0005) and in the group whose off-season lasted longer than 2 months (OR, 0.36; 95% CI, 0.23-0.56; P < .0001). On the contrary, no significant correlation was found between capitellar osteochondritis dissecans and off-season duration. CONCLUSION Off-season duration has a significant correlation with elbow pain and morphologic abnormalities of the medial elbow joint in elementary school-aged baseball players.
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Abstract
Objective The population of Japan is aging rapidly, and, since the aging of patients who undergo total knee arthroplasty (TKA) is also expected, it is necessary to determine the efficacy and safety of TKA among old adult patients. Methods This study retrospectively analyzed the cases of patients who underwent a primary TKA for osteoarthritis at Bange Kosei General Hospital between January 2009 and June 2014 and were postoperatively followed-up for ≥1 year. Among the 2,945 knees of the 1,968 patients, 1,003 knees of 679 patients aged ≥80 years at the time of surgery were designated as the older group, and we compared their cases with those of the younger group of 1,044 knees of 673 patients aged <75 years. Results The rates of improvement of the Japanese Orthopaedic Association (JOA) score were not significantly different between the older and younger groups. Postoperative ranges of motion were significantly improved in both groups. The number of postoperative days of hospital stay in the older group was 2 days longer than that of the younger group. Concerning postoperative complications, confusion, delayed wound healing, and acute heart failure were significantly more frequent in the older group. The frequencies of pneumonia, cerebral infarction, peroneal nerve palsy, and bedsore did not differ significantly. Loosening of implants was observed: older group, n=0 joints; younger group, n=5 joints. The number of prosthetic joint infections: older group, n=5; younger group, n=2 (non-significant). Conclusion The rate of improvement in the JOA score did not differ significantly between the groups. TKA is an effective and safe treatment for osteoarthritis, even in old adult patients, when the surgical indication is based on careful preoperative screening and attention to specific postoperative complications.
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Response to duloxetine in patients with knee pain due to osteoarthritis: an exploratory post hoc analysis of a Japanese Phase III randomized study. J Pain Res 2018; 11:2603-2616. [PMID: 30464579 PMCID: PMC6209071 DOI: 10.2147/jpr.s176036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Purpose To assess whether patients with knee osteoarthritis pain who have early pain reduction or treatment-related adverse events of special interest (TR-AESIs; constipation, decreased appetite, malaise, nausea, somnolence, thirst) with duloxetine treatment are more likely to have later improvements in pain and quality of life (QOL) relative to placebo than patients without these early indicators. Patients and methods This was a post hoc analysis of 14-week randomized trial of Japanese patients with knee osteoarthritis pain (Brief Pain Inventory [BPI]-Severity average pain score ≥4) receiving duloxetine 60 mg/day (n=177 analyzed) or placebo (n=176). Primary trial outcome was change from baseline in BPI-Severity average pain at Week 14. Subgroups included early pain reduction (≥30%, 10%–30%, or <10% decrease in BPI-Severity average pain at Week 4) and early TR-AESIs (with/without TR-AESIs by Week 2). Measures included changes from baseline in BPI-Severity average pain, QOL (BPI-Interference, Western Ontario and McMaster Universities Osteoarthritis Index), Patient Global Impression of Improvement (PGI-I), and response rate (proportion achieving ≥30% or ≥50% pain reduction at Week 14). Results The ≥30% early pain reduction subgroup (n=93) had significantly greater improvements in pain, QOL, and PGI-I and higher ≥30% and ≥50% response rates than placebo; the 10%–30% (n=45) and the <10% (n=33) pain reduction subgroups did not show the same (except 10%–30% group: PGI-I at Week 10 and some QOL at Weeks 10 and/or 14). Both TR-AESI subgroups (with, n=52; without, n=125) had significantly greater improvements in pain, PGI-I, and most QOL measures and higher response rates than placebo. Conclusion Early efficacy responses to duloxetine treatment, but not early TR-AESIs, may predict later pain reduction and QOL improvements in Japanese patients with knee osteoarthritis pain. ClinicalTrials.gov NCT02248480.
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Association Between the Discrepancy in Self-Reported and Performance-Based Physical Functioning Levels and Risk of Future Falls Among Community-Dwelling Older Adults: The Locomotive Syndrome and Health Outcomes in Aizu Cohort Study (LOHAS). J Am Med Dir Assoc 2018; 20:195-200.e1. [PMID: 30409491 DOI: 10.1016/j.jamda.2018.09.009] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2018] [Revised: 08/17/2018] [Accepted: 09/10/2018] [Indexed: 11/16/2022]
Abstract
OBJECTIVES A discrepancy in self-reported and performance-based physical functioning levels is often observed among older adults. We investigated the association of discrepancy in self-reported and performance-based physical functioning levels with risk of future falls among community-dwelling older adults. DESIGN Prospective cohort study. SETTING Two communities in Fukushima Prefecture, Japan. PARTICIPANTS 1379 older adults who took part in the yearly health checkup in both 2009 and 2010. MEASURES The performance-based and self-reported physical functioning levels were evaluated by the Timed Up and Go test and the Short-Form 12 Health Survey (Japanese version) physical functioning subscale, respectively. We divided the participants into 4 groups based on the combinations of low or high performance-based and self-reported physical functioning groups, which were classified by age- and sex-specific reference values. The main outcome was the occurrence of any falls within the 1-year follow-up period, assessed using a self-reported questionnaire. RESULTS A total of 22% of the participants reported the occurrence of a fall during the follow-up period. In multivariable logistic regression analysis, the adjusted odds ratios of the high self-reported and low performance-based, low self-reported and high performance-based, and low self-reported and low performance-based physical functioning groups were 1.10 (95% confidence interval [CI], 0.67-1.82), 1.76 (95% CI, 1.17-2.66), and 1.80 (95% CI, 1.11-2.90), respectively, compared with the high self-reported and high performance-based physical functioning group. CONCLUSIONS Our findings suggest that the discrepancy as high performance-based but low self-reported physical functioning level is associated with an increased risk of future falls in older adults aged 65-89 years. Clinicians should carefully assess older adults whose subjective perception of their physical functioning capacity is lower than those in similar age and sex groups, even if their actual physical functioning appears to be objectively high.
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The prevalence of scapular malalignment in elementally school aged baseball player and its association to shoulder disorder. J Orthop Sci 2018; 23:942-947. [PMID: 30087015 DOI: 10.1016/j.jos.2018.07.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2017] [Revised: 06/07/2018] [Accepted: 07/12/2018] [Indexed: 11/24/2022]
Abstract
BACKGROUND Various shoulder disorders have been reported to be associated with scapulothoracic joint dysfunction in adult overhead athletes. However, little is known about the prevalence of scapular malalignment and its relationship to shoulder injuries in skeletally immature baseball players. The purpose of the current study was to investigate the prevalence of scapular malalignment in elementary school-aged baseball players, as well as its association with shoulder disorder. METHODS One hundred sixty-nine baseball players in higher elementary school grades (aged 11-12 years) were enrolled in this study. Shoulder pain experience pain over the previous one year, as well as other individual and environmental factors were surveyed by a self-completed questionnaire. Scapula malalignment was assessed using still images of both arms both at the side and in an elevated position. The relative position of the dominant scapula to the non-dominant side was assessed by two independent examiners. RESULTS Scapular malalignment was observed in 126 subjects (74.6%), and the dominant scapula tended to deviate inferiorly and medially, as well as tilt anteriorly, compared with the non-dominant side. Forty-four of the 169 subjects (23.8%) experienced shoulder pain over the one year period. The prevalence of shoulder pain was significantly increased with the increasing scapular anterior tilt and the superior shift of the dominant scapula, whereas no significant correlation between shoulder pain and scapular horizontal shift or upward-downward rotation was observed. CONCLUSION About three-quarters of the elementary school-aged baseball players in the current study presented with scapular malalignment, and those with anterior tilt and superior shift of the dominant scapula were at higher risk of shoulder pain.
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Antibacterial effects of nano-imprinted moth-eye film in practical settings. PLoS One 2018; 13:e0198300. [PMID: 30281619 PMCID: PMC6169843 DOI: 10.1371/journal.pone.0198300] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2018] [Accepted: 09/07/2018] [Indexed: 01/29/2023] Open
Abstract
BACKGROUND Recent studies report that surfaces displaying micrometer- or nanometer-sized undulating structures exhibit antibacterial effects. In previous work, we described the use of an advanced nanofabrication technique to generate an artificial biomimetic Moth-eye film by coating a polyethylene terephthalate (PET) film with nanoscale moth-eye protrusions made from a hydrophilic resin. This moth-eye film exhibited enhanced antibacterial effects in in vitro experiments. The aim of the present study was to verify the antibacterial efficacy of the Moth-eye film in practical environments. MATERIALS AND METHODS The antibacterial effects of three types of film (Moth-eye film, Flat film, and PET film) were compared. Sample films were pasted onto hand washing basins at the testing locations. After several hours, bacteria were collected from the surface of the sample films with one of three kinds of culture media stamper (to permit identification of bacterial species). The stampers were incubated for 48 hours at 35°C, and the numbers of colonies were counted. RESULTS AND DISCUSSION The number of common bacteria including E. coli and S. aureus obtained from the Moth-eye film was significantly lower than those from the PET film (p<0.05) and Flat film at 1 hour (p<0.05). This study found that the Moth-eye film showed a long-term (6h) antibacterial effect and the Moth-eye structure (PET coated with nanoscale cone-shaped pillars) demonstrated a physical antibacterial effect from earlier time points. Therefore, the Moth-eye film appears to have potential general-purpose applications in practical environments.
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Establishment and Characterization of a Novel Human Clear-cell Sarcoma of Soft-tissue Cell Line, RSAR001, Derived from Pleural Effusion of a Patient with Pleural Dissemination. Anticancer Res 2018; 38:5035-5042. [PMID: 30194147 DOI: 10.21873/anticanres.12822] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2018] [Revised: 07/20/2018] [Accepted: 07/24/2018] [Indexed: 11/10/2022]
Abstract
BACKGROUND/AIM Clear cell sarcoma (CCS) of soft tissue is exceedingly rare and frequently exhibits aggressive behavior. Toward the goals of improving the aggressive course and poor prognosis of CCS, and establish new therapeutic methods, molecular genetic and biological characterizations of CCS are required. MATERIALS AND METHODS A new human CCS cell line (designated RSAR001) was established from the pleural effusion of a 44-year-old man with multiple lung metastases and pleural dissemination. The cell line and its xenograft were characterized including their morphology, immunohistochemistry, cytogenetic analysis, reverse transcription-polymerase chain reaction, direct sequencing analysis, and fluorescence in situ hybridization analysis. RESULTS The cell line has been maintained for over 12 months with more than 50 passages. RSAR001 cells exhibited a fascicular or diffuse growth pattern of short spindle- or oval-shaped cells with clear cytoplasm in heterotransplanted tumor, that was similar to the primary tumor. Immunophenotypically, RSAR001 cells in vitro and in vivo exhibited almost the same characteristics as the primary tumor. Cytogenetic analyses revealed a translocation, t(12;22)(q13;q12). Reverse transcription-polymerase chain reaction and direct sequencing analysis detected transcripts of the Ewing sarcoma breakpoint region 1-activating transcription factor 1 (EWSR1-ATF1) type 1 fusion gene. Fluorescence in situ hybridization using a break-apart probe for the EWSR1 gene on 22q12 showed a rearrangement. CONCLUSION These findings indicate that the RSAR001 cell line harbors EWSR1-ATF1 type 1 chimeric fusion gene, which is specific to CCS. RSAR001 cells might be useful for investigating biological behaviors and developing new treatments such as molecular-targeting antitumor drugs or immunological drugs for CCS.
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Postoperative neck symptoms of posterior approach for cervical compressive myelopathy: Expansive open-door laminoplasty vs. segmental partial laminectomy. Fukushima J Med Sci 2018; 64:54-59. [PMID: 29780055 PMCID: PMC6141451 DOI: 10.5387/fms.2017-20] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2017] [Accepted: 04/20/2018] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Laminoplasty is widely accepted as a standard treatment of cervical compressive myelopathy. However, due to the risk of postoperative complications such as neck symptoms, segmental partial laminectomy (SPL) is performed instead, which results in fewer postoperative symptoms. The aim of this study was to describe the difference in the incidence and severity of postoperative neck symptoms between traditional C3-C7 expansive open-door laminoplasty (ELAP) and SPL. METHODS A retrospective and comparative study was performed regarding neck complications following the two surgical procedures. Twenty patients underwent SPL, and an additional 20 age- and gender-matched patients underwent traditional C3-C7 ELAP. Preoperative and postoperative JOA scores were measured, and postoperative neck symptoms in both groups were evaluated using a self-administered questionnaire, according to the Neck Pain and Disability Scale. RESULTS The total incidence of postoperative neck symptoms in the SPL group was similar to that in the ELAP group; however, the severity of symptoms was remarkably lower in the SPL group than in the ELAP group. CONCLUSIONS SPL seems to be a better procedure for reducing postoperative neck symptoms, when compared with C3-C7 ELAP.
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Safety and efficacy of duloxetine in Japanese patients with chronic knee pain due to osteoarthritis: an open-label, long-term, Phase III extension study. J Pain Res 2018; 11:1391-1403. [PMID: 30104894 PMCID: PMC6074806 DOI: 10.2147/jpr.s171395] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Purpose To assess long-term safety, tolerability, and efficacy of duloxetine in Japanese patients with chronic knee pain due to osteoarthritis. Methods In this open-label extension study (NCT02335346), Japanese patients with knee osteoarthritis and pain (Brief Pain Inventory [BPI] - Severity average pain score ≥4 at start of randomized trial) who had previously received duloxetine 60 mg/day or placebo for 14 weeks in a double-blind randomized trial entered the extension and received duloxetine 60 mg/day for 48 weeks. The primary outcome was safety/tolerability, secondary outcomes were change in BPI-Severity (BPI-S) average pain, BPI-Interference (BPI-I), Patient Global Impression-Improvement (PGI-I), Clinical Global Impression-Improvement (CGI-I), 36-item Short-Form Health Survey (SF36), and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), and exploratory outcomes were knee range of motion (efficacy outcome) and Kellgren-Lawrence grade (safety outcome). Results Of 323 patients who completed the randomized trial, 93 (50 placebo, 43 duloxetine) entered the extension. Most patients (85, 91.4%) experienced an adverse event, most commonly constipation, nasopharyngitis, somnolence, and dry mouth (≥10% of patients). There were eight serious adverse events in seven patients and no deaths. No obvious duloxetine-related changes were observed in laboratory tests, vital signs, or electrocardiograms. The change from baseline in BPI-S average pain score was significant throughout the extension. Significant reductions in BPI-I, PGI-I, CGI-I, WOMAC, and SF36 scores were also maintained through 52 weeks. There were no substantial changes in range of motion or Kellgren-Lawrence grade. Conclusion In Japanese patients with chronic knee pain due to osteoarthritis, long-term treatment with duloxetine was well tolerated and associated with sustained improvements in pain and health-related quality of life without radiographic deterioration.
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Prospective predictors of exacerbation status in severe asthma over a 3-year follow-up. Clin Exp Allergy 2018; 48:1137-1146. [PMID: 29781543 DOI: 10.1111/cea.13170] [Citation(s) in RCA: 40] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2017] [Revised: 03/14/2018] [Accepted: 03/29/2018] [Indexed: 12/15/2022]
Abstract
BACKGROUND A predisposition to exacerbations is being recognized as a distinct phenotype with "previous exacerbations" representing the strongest clinical factor associated with future exacerbation. Thus, to identify additional novel biomarkers associated with asthma exacerbations, "past exacerbation status" must be included as a confounding factor. OBJECTIVE This study aimed to characterize the clinical and biomarker features associated with asthma exacerbations in severe asthma. METHODS We evaluated clinical parameters from 105 severe asthmatics yearly for 3 years, as well as their exacerbation status. We classified the subjects into 3 groups: (i) consistent non-exacerbators (CNE, subjects who did not experience any exacerbation over the 3-year period); (ii) consistent frequent exacerbators (CFE, subjects with frequent exacerbation, defined as those who had 2 or more exacerbations within 1 year, throughout the 3-year period); and (iii) intermittent exacerbators (IE). We conducted multivariate analysis for comparisons among the groups for multiple factors, including several Th2-related biomarkers, in addition to the "past exacerbation status." RESULTS Thirty-nine subjects were classified as CNE, 15 as CFE, and 51 as IE. Frequent exacerbations in the previous year predicted exacerbations for the following year (P < .001). Among the several Th2-related biomarkers, only FeNO was associated with exacerbation status. When we analysed the data after the second visit, the impact of FeNO on predicting future exacerbation remained significant, even after considering the exacerbation status during the first year (P < .05). CONCLUSIONS AND CLINICAL RELEVANCE Measurement of FeNO has a significant potential to predict future asthma exacerbation, which is independent of the "past exacerbation history."
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Association between vision-specific quality of life and falls in community-dwelling older adults: LOHAS. PLoS One 2018; 13:e0195806. [PMID: 29689064 PMCID: PMC5978984 DOI: 10.1371/journal.pone.0195806] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2017] [Accepted: 03/29/2018] [Indexed: 11/18/2022] Open
Abstract
Background Falls and fall-related fractures are a major public health problem among the older adults. Although objective measures of poor vision have been reported to be associated with falls, the association of self-reported visual function and vision-specific quality of life (QOL) with falls has been inconsistent across several studies. We investigated the association of self-reported visual function and vision specific QOL with falls in community-dwelling older adults. Methods We conducted a cross-sectional analysis using the baseline data from participants of the Locomotive Syndrome and Health Outcome in Aizu Cohort Study (LOHAS), which is an ongoing population-based cohort study to evaluate the association of physical dysfunction with the clinical outcomes in community-dwelling people. In the present study, the participants aged over 65 years in 2010 were eligible. The exposure variable was the composite score of the VFQ-J11, which was newly developed using item response theory to evaluate vision specific QOL, and the self-reported outcomes were any fall and frequent falls (≥2) over a 1-month period. We estimated odds ratios using separate logistic regression models adjusted for relevant confounding factors. Results Among 1624 participants, the median (interquartile range) composite score of VFQ-J11 was 86.8 (76.0–95.9). Any fall and frequent falls were reported by 13.9% and 5.4% of participants, respectively. The composite score of the VFQ-J11 was significantly associated with both frequent falls (adjusted ORs per 10 points, 0.80; 95% CI, 0.68–0.93) and any fall (adjusted ORs per 10 points, 0.84; 95% CI, 0.76–0.94). Conclusions We found that the composite score of the VFQ-J11 was associated with falls in community-dwelling older adults. Detecting individuals with visual impairments associated with falls using the VFQ-J11 and improvement in the score by interventions could prevent falls. We may consider adding self-reported visual function and vision-specific QOL to conventional risk factors for fall among older adults.
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