scholarly journals Principles of Valgus Intertrochanteric Osteotomy (VITO) after Femoral Neck Nonunion

2018 ◽  
Vol 2018 ◽  
pp. 1-9
Author(s):  
D. Banaszek ◽  
D. Spence ◽  
P. O’Brien ◽  
K. Lefaivre
Keyword(s):  
Risk Factors ◽  
Femoral Neck ◽  
Proximal Femur ◽  
Treatment Options ◽  
Intertrochanteric Osteotomy ◽  
Valgus Osteotomy ◽  
Challenging Problem ◽  
The Individual ◽  
Technical Considerations

Nonunion is a relatively rare, yet challenging problem after fracture of the femoral neck. Risk factors include verticality of the fracture line and presence of comminution of the posteromedial calcar, as well as quality of reduction. Treatment options consist of valgus intertrochanteric osteotomy versus arthroplasty. Treatment should be tailored to the individual patient, taking into account patient age and activity demands. This review outlines the principles and technical considerations for valgus osteotomy of the proximal femur in the setting of femoral neck nonunion.

scholarly journals Neglected femoral neck fractures in cerebral palsy: a narrative review

2020 ◽  
Vol 5 (1) ◽  
pp. 58-64
Author(s):  
Giuseppe Toro ◽  
Antimo Moretti ◽  
Marco Paoletta ◽  
Annalisa De Cicco ◽  
Adriano Braile ◽  
...  
Keyword(s):  
Cerebral Palsy ◽  
Femoral Neck ◽  
Motor Function ◽  
Treatment Options ◽  
High Morbidity ◽  
Fibular Graft ◽  
Motor Impairments ◽  
High Prevalence ◽  
Neck Fracture

Hip fractures are severe conditions with a high morbidity and mortality, especially when the diagnosis is delayed, and if formulated over 30 days after the injury, is termed a ‘neglected femoral neck fracture’ (NFNF). Cerebral palsy (CP) is probably one of the major risk factors for NFNF in Western countries, mainly because of both cognitive and motor impairments. However, considering the high prevalence of fractures in these patients, the incidence of NFNF in this population is probably underestimated, and this condition might result in persistent hip or abdominal pain. Several techniques are available for the treatment of NFNF (i.e. muscle pedicle bone graft, fixation with fibular graft, valgisation osteotomy), but most of them could affect motor function. Motor function must be preserved for as long as possible, in order to enhance the quality of life of CP patients. After discussing published NFNF cases in CP patients and available treatment options, a practical approach is proposed to facilitate the orthopaedic surgeon to both early identify and appropriately manage these challenging fractures. Cite this article: EFORT Open Rev 2020;5:58-64. DOI: 10.1302/2058-5241.5.190019

Female sexual dysfunction: a problem hidden in the shadows

2021 ◽  
Vol 27 ◽  
Author(s):  
Konstantinos P. Imprialos ◽  
Konstantinos Koutsampasopoulos ◽  
Aleksandra Katsimardou ◽  
Sofia Bouloukou ◽  
Iakovos Theodoulidis ◽  
...  
Keyword(s):  
Risk Factors ◽  
Sexual Dysfunction ◽  
Female Sexual Dysfunction ◽  
Treatment Options ◽  
Public Health Problem ◽  
Management Options ◽  
Significant Public Health Problem ◽  
Significant Public Health ◽  
Cv Disease

Background: Female sexual dysfunction (FSD) has mainly been underdiagnosed and undertreated due to the lack of concrete definitions, validated assessment methods, and efficient treatments. However, during the last few decades, there has been significant progress in the clinical management and research of FSD. Objective: The purpose of this review is to describe the pathophysiology of FSD, report the prevalence of the disease in the setting of cardiovascular (CV) risk factors and disease, and review current and under investigation treatment options. Methods: A comprehensive literature review was performed to identify studies examining the association of FSD with CV risk factors and/or disease and studies reporting appropriate management options. Results: The prevalence of FSD is increased in the general population (approximately 40%) and is significantly higher in patients with hypertension, diabetes mellitus, and dyslipidemia. In patients with overt CV disease, FSD is even more prevalent (up to 90%). The cause of FSD is multifactorial and includes various vascular, hormonal, interpersonal, and psychological factors, which are all intertwined. Several treatment options exist that are efficient in improving female sexual function, while a cluster of other alternatives has been shown to offer benefits. Conclusion: FSD is a significant public health problem with a great impact on the patients’ quality of life. In the setting of increased CV burden, FSD is even more prevalent. Increased awareness is needed for the physician to establish a trustful environment with the patient, discuss such issues, and offer suitable management options.

Arthrogryposis

2019 ◽  
pp. 191-196
Author(s):  
Robin D. Clark ◽  
Cynthia J. Curry
Keyword(s):  
Quality Of Life ◽  
Risk Factors ◽  
Clinical Case ◽  
Treatment Options ◽  
Recurrence Risk ◽  
Case Presentation ◽  
Joint Mobilization ◽  
Intensive Use ◽  
Incidence Risk

This chapter reviews the incidence, risk factors, genetics, recurrence risk, and epidemiology of arthrogryposis. The most common and clinically recognizable type among the congenital contractures is amyoplasia, and treatment options are improving the quality of life for these patients. The distal arthrogryposes are mostly autosomal dominant and caused by an increasing number of genes including variants in PIEZ02 and MYH3 among several others. The lethal contracture syndromes have an expanding number of causes many of which are autosomal recessive. The majority of these conditions are recognized on US. In viable syndromes the early and intensive use of physical therapy is critical and can result in significant joint mobilization. The clinical case presentation features an infant with lethal multiple pterygia syndrome.

scholarly journals Quality of life in chronic conditions using patient-reported measures and biomarkers: a DEA analysis in type 1 diabetes

2019 ◽  
Vol 9 (1) ◽  
Author(s):  
Sixten Borg ◽  
Ulf-G. Gerdtham ◽  
Katarina Eeg-Olofsson ◽  
Bo Palaszewski ◽  
Soffia Gudbjörnsdottir
Keyword(s):  
Quality Of Life ◽  
Risk Factors ◽  
Type 1 Diabetes ◽  
Patient Reported Outcomes ◽  
Efficiency Analysis ◽  
Outcomes Measures ◽  
Patient Reported ◽  
The Individual

Abstract Background A chronic disease impacts a patient’s daily life, with the burden of symptoms and managing the condition, and concerns of progression and disease complications. Such aspects are captured by Patient-Reported Outcomes Measures (PROM), assessments of e.g. wellbeing. Patient-Reported Experience Measures (PREM) assess patients’ experiences of healthcare and address patient preferences. Biomarkers are useful for monitoring disease activity and treatment effect and determining risks of progression and complications, and they provide information on current and future health. Individuals may differ in which among these aspects they consider important. We aimed to develop a measure of quality of life using biomarkers, PROM and PREM, that would provide an unambiguous ranking of individuals, without presuming any specific set of importance weights. We anticipated it would be useful for studying needs and room for improvement, estimating the effects of interventions and comparing alternatives, and for developing healthcare with a broad focus on the individual. We wished to examine if efficiency analysis could be used for this purpose, in an application to individuals with type 1 diabetes. Results We used PROM and PREM data linked to registry data on risk factors, in a large sample selected from the National Diabetes Registry in Sweden. Efficiency analysis appears useful for evaluating the situation of individuals with type 1 diabetes. Quality of life was estimated as efficiency, which differed by age. The contribution of different components to quality of life was heterogeneous, and differed by gender, age and duration of diabetes. Observed quality of life shortfall was mainly due to inefficiency, and to some extent due to the level of available inputs. Conclusions The efficiency analysis approach can use patient-reported outcomes measures, patient-reported experience measures and comorbidity risk factors to estimate quality of life with a broad focus on the individual, in individuals with type 1 diabetes. The approach enables ranking and comparisons using all these aspects in parallel, and allows each individual to express their own view of which aspects are important to them. The approach can be used for policy regarding interventions on inefficiency as well as healthcare resource allocation, although currently limited to type 1 diabetes.

Pelvic Organ Prolapse

2018 ◽  
Author(s):  
Lennox Hoyte ◽  
Renee Bassaly ◽  
Stuart Hart ◽  
Mona McCullough ◽  
Elisha Jackson
Keyword(s):  
Quality Of Life ◽  
Risk Factors ◽  
Pelvic Organ Prolapse ◽  
Healthcare Provider ◽  
Treatment Options ◽  
Pelvic Organ ◽  
Vaginal Wall ◽  
Life Threatening ◽  
Surgical Options

Pelvic organ prolapse (POP) is the descent of one of more aspects of the vagina and/or uterus. Evaluation of POP always begins with a thorough history and physical examination. Management choices include observation, conservative options, and surgical options. Surgical management is divided into two categories, which are restorative and obliterative. It is important to counsel patients that although POP may affect quality of life, it is not life-threatening. This chapter is designed to guide the healthcare provider with a review of epidemiology, anatomy, evaluation, and management of POP. The chapter contains 14 figures that illustrate examples of common examination findings, devices, and treatment options. Also, there are 5 tables that provide concise reference materials to help guide the healthcare provider. This review contains 91 references, 14 figures, and 6 tables. Key Words: constipation, mesh, pain, pelvic floor, pessary, POP-Q, risk factors, surgery, vaginal wall

Pelvic Organ Prolapse

2018 ◽  
Author(s):  
Lennox Hoyte ◽  
Renee Bassaly ◽  
Stuart Hart ◽  
Mona McCullough ◽  
Elisha Jackson
Keyword(s):  
Quality Of Life ◽  
Risk Factors ◽  
Pelvic Organ Prolapse ◽  
Healthcare Provider ◽  
Treatment Options ◽  
Pelvic Organ ◽  
Vaginal Wall ◽  
Life Threatening ◽  
Surgical Options

Pelvic organ prolapse (POP) is the descent of one of more aspects of the vagina and/or uterus. Evaluation of POP always begins with a thorough history and physical examination. Management choices include observation, conservative options, and surgical options. Surgical management is divided into two categories, which are restorative and obliterative. It is important to counsel patients that although POP may affect quality of life, it is not life-threatening. This chapter is designed to guide the healthcare provider with a review of epidemiology, anatomy, evaluation, and management of POP. The chapter contains 14 figures that illustrate examples of common examination findings, devices, and treatment options. Also, there are 5 tables that provide concise reference materials to help guide the healthcare provider. This review contains 91 references, 14 figures, and 6 tables. Key Words: constipation, mesh, pain, pelvic floor, pessary, POP-Q, risk factors, surgery, vaginal wall

scholarly journals Factores protectores y de riesgo de trastornos de conducta y trastorno por déficit de atención e hiperactividad. Una revisión sistemática.

2018 ◽  
Vol 23 (1) ◽  
pp. 59
Author(s):  
Cristian Villanueva-Bonilla ◽  
Ángela Magnolia Ríos-Gallardo
Keyword(s):  
Risk Factors ◽  
Attention Deficit Hyperactivity Disorder ◽  
Conduct Disorder ◽  
Attention Deficit ◽  
Family Factors ◽  
Hyperactivity Disorder ◽  
Revisión Sistemática ◽  
The Individual ◽  
The Relationship

  Abstract: Protective and risk factors for conduct disorder and attention deficit–hyperactivity disorder. A systematic review. Conduct disorder (CD) and attention deficit-hyperactivity disorder (ADHD) are the most frequent clinical disorders in children and adolescents. The aim of the review was to identify the protective and risk factors of CD and ADHD to guide the design of intervention programs that allow to modify the risks and strengthen the characteristics that prevent manifestation of the symptomatology. The existing literature was analyzed from January 2012 to June 2017 through a search conducted in Scopus, Pubmed, Sciencedirect and PsycINFO. In conclusion, individual and family factors are predominant in both types of disorder, where variables of both protection and risk were found, with the emotional and cognitive variables being the most studied in the individual factors and in family factors the quality of the relationship between parents and son.Resumen: El trastorno de conducta (TC) y el trastorno de déficit de atención y/o hiperactividad (TDAH) son de los trastornos clínicos más frecuentes en niños y adolescentes. El objetivo de la revisión fue identificar los factores protectores y de riesgo de TC y TDAH para orientar el diseño de programas de intervención que permitan modificar los riesgos y fortalecer las características que contribuyen a la no manifestación de la sintomatología. Se analizó la literatura existente desde enero de 2012 hasta junio de 2017 mediante una búsqueda realizada en Scopus, Pubmed, Sciencedirect y PsycINFO. En conclusión, el estudio de los factores individuales y familiares son predominantes en ambos tipos de trastorno, en donde se encontraron variables tanto de protección como de riesgo, siendo las variables emocionales y cognitivas las más estudiadas en los factores individuales y la calidad de la relación entre padres e hijo en los factores familiares.

scholarly journals Acne Vulgaris Burden, Risk Factors, Lifestyle Modification Influence and Treatment Options – A Review

2021 ◽  
pp. 284-291
Author(s):  
Moteab Alotaybi ◽  
Bashaer Almahdi ◽  
Abdulaziz Bokhari ◽  
Mohammed Altaf ◽  
Faisal Alagbari ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Risk Factors ◽  
Lifestyle Modification ◽  
Acne Vulgaris ◽  
Treatment Options ◽  
Psychological Impact ◽  
Multiple Perspectives ◽  
Lifestyle Modifications ◽  
High Importance

Acne vulgaris is a widespread health issue affecting teenagers, young adults, and adults. The prevalence of this unpleasant condition varies between populations. A thorough literature review was carried out to discuss this underestimated issue through multiple perspectives. The search found that acne vulgaris has a substantial negative psychological impact on individuals leading to low quality of life and less productivity, yet it is usually neglected. Various factors, modifiable and non-modifiable) were associated with the progression of acne, such as family history, genetics, and diet, yet others were controversial. Lifestyle modifications are of high importance since they may contribute to the development of acne. Numerous anti-acne drugs are available in the form of topical and systemic, however, topical treatment options in general are preferred thanks to their effectiveness and less severe side effects.

scholarly journals Cemented versus cementless megaprosthesis in proximal femur metastatic disease: A systematic review

2020 ◽  
Author(s):  
Maria Serena Oliva ◽  
Raffaele Vitiello ◽  
Michele Cauteruccio ◽  
Elisa Pesare ◽  
Giuseppe Rovere ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Metastatic Disease ◽  
Proximal Femur ◽  
Functional Outcomes ◽  
Treatment Options ◽  
Long Bone ◽  
Infection Rates ◽  
Surgical Options ◽  
Lower Infection

The proximal femur is the long bone most commonly affected by metastatic disease. There are many treatment options, such as hip megaprostheses. A topic still widely debated in literature is the use of cemented or uncemented megaprostheses in this kind of patients. The purpose of this review is to examine both these surgical options to understand which of them should be preferred in metastatic patients. Twelve articles were finally included in the review. Eight authors used cemented mega - prostheses, two cementless megaprostheses and two authors used both techniques. Better functional outcomes and lower infection rates were found in cementless mega - prostheses. More studies have to be performed to choose the better technique and improve patients’ quality of life.

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