scholarly journals Radiographic Outliers, Revisions, and Functional Outcomes in Fixed-Bearing Medial Unicompartmental Arthroplasty

2021 ◽  
Vol 4 (1) ◽  
Author(s):  
Colin Harris ◽  
Evan R. Deckard ◽  
Mary Ziemba-Davis ◽  
Kevin A. Sonn ◽  
R. Michael Meneghini

Background and Hypothesis: Unicompartmental Knee Arthroplasty (UKA) is a technically demanding procedure vulnerable to errors in component positioning. Recent studies suggest robotic-assistance improves precision of implant placement, minimizes outliers, and improves survivorship. However, we have previously demonstrated an experienced surgeon can match robotic accuracy. This study evaluated revision rates and functional outcomes of radiographic outliers in manual UKA. Experimental Design or Project Methods: A retrospective review of 222 consecutive fixed-bearing medial UKAs was conducted. Implant positioning and alignment were assessed radiographically measuring tibial coronal (TCA), femoral coronal (FCA), tibial sagittal (TSA) and femoral sagittal (FSA) angles as well as implant overhang. UCLA Activity Level and all-cause survivorship were evaluated. Student’s t-test, Chi square, and Kaplan Meier curves were used in analyses with alpha ≤ .05 designating statistical significance. Results: Using previously published alignment goals, our manual UKAs achieved the following targets: 92% for TCA, 100% for FCA, 88% for TSA, and 100% for FSA. For implant overhang, 100% met medial, anterior, and posterior targets. Our manual UKAs achieved desired alignment and overhang goals more frequently than previously published manual success. Survivorship free from aseptic revision in this study was 96% at 8.5 years. Additionally, there was no difference in UCLA Activity Level improvement comparing outliers and non-outliers (p³0.159). Conclusion and Potential Impact: Manual UKAs performed by an experienced surgeon showed improved success in achieving alignment and implant overhang goals compared to published manual UKA data and similar success compared to published robotic-assisted UKA data. We found no differences in revision rates or functional outcomes between outliers and non-outliers using previously published targets. For robotic assistance to be cost effective, it must demonstrate improved outcomes or survivorship when compared to manual UKAs. Our results contradict recently published claims that manual alignment outliers and failure rates fail to meet expectations for UKA.

2020 ◽  
Author(s):  
Ferid Krupic ◽  
Kemal Grbic ◽  
Olof Westin ◽  
Eleonor Svantesson ◽  
Eric Hamrin Senorski

Abstract BackgroundOrgan donation is a personal choice and many ethical, legal, medical, organisational and social factors are involved. It is possible to transplant some organs from live donors and others only from deceased donors. Nevertheless, the shortage of organs worldwide is a problem. Gender differences may cause decission and willingnes to organ donation. Methods A total of 60 informants (30 men and 30 women), born in Bosnia and Herzegovina and living in Sweden were available for follow-up. Data was collected by a questionnaire and statisticaly analysed according to the chi-square test, the D’Agostino-Pearson test for checking normality of continuous data distribution and, based on the distribution of results, Student’s t test or the Mann-Whitney test. Statistical significance was defined as p < 0.05.Results The result showed that significant differences between men and women was highest in the question about definition of transplantation (p<0.0001), information about organ donation (p<0.0001), knowledge about OD (p<0.0001), importance about OD (p<0.003), religious permitting to OD (p=0.0001), religious opposite to OD (p=0.0007), donate to a special person or not (p=0.0062), religion as factor to donate (p=0.0007). It was not better in question about having the donor card (p<0.0001). ConclusionsWomen were found to have more positive attitudes toward organ donation than men. Different socioeconomic factors, cultural beliefs, a higher level of religiousness, a higher level of information and knowledge about organ donation, as well as the ownership of donor cards, may result in a better perception of and willingness to participate organ donation. More knowledge of the religious understanding of organ donations and the reduction in prejudice among respondents would make the awareness and desire for organ donation even greater.


2020 ◽  
pp. 025371762095756
Author(s):  
Esther Chinneimawi ◽  
Padmavathi Nagarajan ◽  
Vikas Menon

Background: Very few Indian studies have explored disability among patients with somatoform disorder and the burden experienced by their caregivers. We aimed to assess the levels of disability among patients with somatoform disorder and the levels of burden among their caregivers and compare these parameters against patients with schizophrenia. Methods: Participants included adults with a diagnosis of somatoform disorders (F45.0–F 45.9) ( n = 28) or schizophrenia (F20.0–F20.9) ( n = 28) diagnosed as per the International Classification of Diseases, Tenth Revision ( ICD-10), clinical descriptions, and diagnostic guidelines, as well as their caregivers. The WHO Disability Assessment Schedule 2.0 and Family Burden Interview Schedule were used to assess patient disability and caregiver burden, respectively. Independent Student’s t-test or chi-square test was used to compare relevant sociodemographic and clinical parameters. Results: Out of 56 patients, the mean (±SD) age of the sample was 38.6 (±10.5) years. Females constituted a slender majority of the sample ( n = 29, 51.8%). The mean disability score of patients with somatoform disorders was slightly higher (83.6 ±20.9) than that of patients with schizophrenia (82.3 ±16.7). Similarly, the mean burden score of caregivers of patients with somatoform disorders was nominally higher (18.96 ±9.9) than that of caregivers of patients with schizophrenia (15.7 ±9.7). Neither of these differences approached statistical significance (P > 0.05). Conclusion: Patients with somatoform disorders experience considerable levels of disability, and their caregivers go through various levels of burden in their daily life that is comparable to schizophrenia.


Author(s):  
Joanna Ratajczak ◽  
Elzbieta Petriczko

Background: Children worldwide are increasingly becoming overweight and obese and developing related health problems, including hypertension, lipid disorders, abnormal glucose tolerance, type 2 diabetes, and secondary psychological disorders. The aim of the study was to determine sociodemographic risk factors that predict an increase in BMI in children at an early school age. Material and method: The study covered 4972 children aged 8–10 years, including boys (N = 2461) and girls (N = 2511). Measurements of basic anthropometric indicators were used, such as body height, body weight, body composition, and physical fitness. The criteria developed by the International Obesity Task Force (IOTF) were adopted. Sociodemographic features were analyzed based on a diagnostic survey. IBM SPSS Statistics v.25 (Mineral Midrange SA, Warsaw, Poland) and IBM SPSS Amos software (Mineral Midrange SA, Warsaw, Poland) were used to perform descriptive statistics, the Kolmogorov-Smirnov test, Pearson′s chi-square test, Student’s t-test, and the Mann-Whitney U test. The statistical significance index was assumed to be p < 0.05, while p < 0.01 was taken as an indicator of a trend which was not completely statistically significant. Results: Both the children and their parents had mainly moderate BMI. A total of 78.7% of children were within the weight norm. Among girls, extreme obesity was two times more frequent than extreme underweight. The examined boys were significantly taller, heavier, and had a higher BMI than girls. There were significant differences between boys and girls in BMI; however, gender alone accounted for less than 1% variance. The influence of parents′ characteristics was much greater, increasing the explained variance to 10%. Body weight of mothers and fathers (p < 0.001), mother′s height (p < 0.01) and both parents′ level of education (p < 0.001) were detected as significant predictors of children’s BMI. Conclusions: The analysis of selected sociodemographic and health factors determining the BMI of the child population indicates the need for preventive action and health promotion both among children and their parents.


Author(s):  
Praveen B. Gautam ◽  
Ashwini Kumar Mishra ◽  
Santosh Kumar

Background: India has the highest tuberculosis (TB) burden in the world. The directly observed treatment strategy is the most systemic and cost-effective approach to the disease. Furthermore, understanding the reasons for treatment outcome is important for the improvement of treatment systems. The objective was to study the treatment outcome of retreatment tuberculosis patients under RNTCP in eastern UP.Methods: A longitudinal cohort study was undertaken among total 205 patients registered in category II under DOTS from June 2015 to May 2016. These patients were followed up to November 2016 till the completion of treatment. At the end of study period, treatment outcomes were analysed. The chi-square test was used to assess the statistical significance of each ratio. P<0.05 was considered significant.Results: Out of 205 re-treatment patients, 174 (84.4%) had pulmonary tuberculosis while 31 (15.1%) had extra-pulmonary TB. In the cohort of category II patients 93 (45.3%) were relapse, 58 (28.2%) belonged to others category, 31 (15.1%) were treatment after loss to follow-up and 23 (11.2%) were on treatment after failure. Maximum patients were male 133 (64.8%) and most of the patients were belonged to the age group of 20-40 years. Among retreatment cases the cure rate for relapse, treatment after failure, treatment after loss to follow-up and others cases were 74.1%, 60.8%, 35.4% and 55.1% respectively.Conclusions: The relapse cases were the most commonly found in the re-treatment category however these patients were more likely to be cured with the category II regimen and treatment after loss to follow-up had high risk of retreatment failure. Continuous monitoring, adherence and treatment completion are essential for controlling the need of retreatment as well as improvement of tuberculosis control programme. 


2020 ◽  
Vol 13 (1) ◽  
pp. 80-86
Author(s):  
Rano K. Sinuraya ◽  
Aida N. Aini ◽  
Cherry Rahayu ◽  
Nasrul Wathoni ◽  
Rizky Abdulah

Background: Appendicitis has a high occurrence and is frequently indicated in pediatric abdominal surgery. However, up to 33% of affected children may not present with distinct symptoms, and young children may be a typical or show delayed presentation of symptoms. Appendectomy is one of the most common emergent surgeries to treat appendicitis. After an appendectomy, prophylaxis antibiotics are required to abate infections at the location of surgery and have been shown to reduce postoperative surgical complications significantly. Objective: The purpose of this investigation was to determine the most cost-effective prophylactic antibiotic combination between ceftriaxone-metronidazole and cefotaxime-metronidazole following appendectomy. Methods: A retrospective observational study was conducted using investigations with a similar design and pediatric medical records from 2011 until 2013 from a referral hospital in Bandung City. All direct medical costs related to pediatric appendectomy were collected and discounted. Independent Student’s t-test and chi-square analysis were used. Results: The average total cost of ceftriaxone-metronidazole was USD 393.83/patient and that of cefotaxime-metronidazole was USD 397.89/patient. There were no significant differences in average direct medical costs between treatments with ceftriaxone-metronidazole and cefotaxime-metronidazole (p=0.383). The analysis suggests that both antibiotic combinations have the same effectiveness and cost. For the combinations of ceftriaxone-metronidazole and cefotaxime-metronidazole, approximately USD 1.88 and USD 2.28 were required, respectively, to reduce one day of hospitalization after an appendectomy. Additionally, to increase one percent of cure rate, an amount of USD 19.70 and USD 24.89 was required for ceftriaxone-metronidazole and cefotaxime-metronidazole, respectively. Conclusion: Both therapies investigated were effective as a postoperative antibiotic. However, the combination of ceftriaxone and metronidazole may be more cost-efficient.


2009 ◽  
Vol 127 (6) ◽  
pp. 329-334 ◽  
Author(s):  
João Felício Rodrigues-Neto ◽  
Maria Fernanda Santos Figueiredo ◽  
Anderson Antônio de Faria

CONTEXT AND OBJECTIVE: Homeopathy is a therapeutic system that uses small doses of substances to stimulate autoregulatory and self-healing processes. The aim of this study was to investigate the prevalence of the use of homeopathy by the population of Montes Claros, Brazil, and the socioeconomic profile of users. DESIGN AND SETTING: Probabilistic cross-sectional study with cluster sampling, in the city of Montes Claros, Minas Gerais. METHODS: This study was conducted by applying semi-structured questionnaires. The sample was composed of 3,080 people. For the statistical analysis, Student's t test and the chi-square test were used. The statistical significance level used was P < 0.05. RESULTS: We interviewed 3,090 people. The prevalence of the use of homeopathy was 2.4%. The factors associated with its use were female gender, schooling and income. The main reason that led to seeking homeopathy was "Conventional treatment did not have any effect". For 70.2% of the users, the cost of the treatment was considered reasonable or cheap. About 73% were satisfied or very satisfied with the treatment received through homeopathy. CONCLUSIONS: The prevalence of the use of homeopathy found here was less than that reported in other countries. People with higher income and schooling levels used homeopathy more frequently. There was higher prevalence among women. Most users declared themselves satisfied with the treatment received.


2011 ◽  
Vol 18 (01) ◽  
pp. 97-101
Author(s):  
ZULFIQAR ALI ◽  
TANVEER AHMAD ◽  
IRSHAD AHMAD ◽  
Muhammad Suhail Amir ◽  
AG Rehan

Objective: The aim of this study was to compare the outcomes and morbidities of laparoscopic appendicectomy (LA) and open appendicectomy (OA) in patients with acute appendicitis. Design: Interventional study. Setting: The study was conducted at Madina Teaching Hospital, University Medical & Dental College, Faisalabad. Period: From June 2007 to August 2009. Materials and Methods: The study group consisted of two hundred patients suffering from acute appendicitis. One hundred patients underwent LA and one hundred patients underwent OA. Comparison was based on operating time, complications, requirements for postoperative analgesia, time until resumption to regular diet, hospital stay, and return to full activity in days. Comparisons were made between continuous variables using Student’s t test of the means and were made between proportions using Fischer’s exact or chi-square testing where appropriate. Statistical significance was taken to be a p value of .05 or less. Results: Of the hundred patients, five patients (5%) had the procedure converted to open surgery. The rate of infection was significantly lower in patients undergoing LA. The median length of stay was significantly shorter after LA (2 days after LA, 5 days after OA, P < 0.05) than after OA. The operating time was shorter {OA: 25 min (median), LA: 30 min (median), P > .05} in patients undergoing open appendicectomy compared to laparoscopic appendicectomy. Conclusion: LA is associated with increased clinical comfort in terms of fewer wound infections, faster recovery, earlier return to work and improved cosmesis.


Rev Rene ◽  
2021 ◽  
Vol 22 ◽  
pp. e61458
Author(s):  
Sarah Vieira Figueiredo ◽  
Thereza Maria Magalhães Moreira ◽  
Daniella Barbosa Campos ◽  
Edna Maria Camelo Chaves ◽  
Ilvana Lima Verde Gomes

Objective: to analyze the effect of reading an educational booklet about sickle cell disease related to family members’ knowledge. Methods: quasi-experimental study, with 20 children´s family members with sickle cell disease. A form was used before and 30 days after medical consultation (pre- and post-test). The booklet was given to the family member on the day of the consultation. Analysis was performed using Statistical Package for the Social Science version 20 with the Shapiro-Wilk, Student’s t, McNemar’s chi-square and Odds Ratio statistical tests. Results: all participants were female, mostly mothers aged 20 to 30 years with high school education. The analysis revealed increase in the number of correct answers after reading the booklet with statistical significance (p<0.001). Conclusion: the reading of the booklet and the strategies used to encourage it contributed to increase the knowledge of family members about some disease aspects, enabling them to better deal with this disease.


Author(s):  
Novikova ◽  
SP Romanenko ◽  
MA Lobkis

Introduction: In the Russian Federation, much attention is traditionally paid to military education and training. A special place in its structure is occupied by the system of cadet classes and corps. A distinctive feature of the learning mode in such institutions is a combined effect of standard and specific factors of indoor school environment and intensive physical activity owing to sports, applied military and drill training. No evidence-based methods of establishing nutrient requirements of children in modern conditions of cadet corps have been developed so far, which predetermines the potential of transforming nutrition from a health-saving factor into a health risk factor. Our objective was to provide a scientific substantiation of the model of healthy nutrition for students of cadet-type educational establishments. Methods: The statistical significance of the correlation was evaluated using the Student’s t-test. Correlation and regression analyses were used to assess cause-and-effect relationships. The Pearson correlation coefficient (rxy) was used as an indicator of the strength of the relationship between quantitative indicators x and y, both having a normal distribution. Correlation coefficient (rxy) values were interpreted in accordance with the Chaddock scale. For the purpose of statistical modeling, the method of multiple linear regressions was used. Conclusions: We substantiated the innovative model of organizing healthy nutrition for students of cadet-type schools based on the correlation and regression analyses with determination of statistical significance of the studied characteristics. Its efficiency indicators include an increase in average functional capabilities of students by more than 10 % and a reduction in the probability of developmental disorders by more than 25 %.


2020 ◽  
Vol 103 (6) ◽  
pp. 548-552

Objective: To predict the quality of anticoagulation control in patients with atrial fibrillation (AF) receiving warfarin in Thailand. Materials and Methods: The present study retrospectively recruited Thai AF patients receiving warfarin for three months or longer between June 2012 and December 2017 in Central Chest Institute of Thailand. The patients were classified into those with SAMe-TT₂R₂ of 2 or less, and 3 or more. The Chi-square test or Fisher’s exact test was used to compare the proportion of the patients with poor time in therapeutic range (TTR) between the two groups of SAMe-TT₂R₂ score. The discrimination performance of SAMe-TT₂R₂ score was demonstrated with c-statistics. Results: Ninety AF patients were enrolled. An average age was 69.89±10.04 years. Most patients were persistent AF. An average CHA₂DS₂-VASc, SAMe-TT₂R₂, and HAS-BLED score were 3.68±1.51, 3.26±0.88, and 1.98±0.85, respectively. The present study showed the increased proportion of AF patients with poor TTR with higher SAMe-TT₂R₂ score. The AF patients with SAMe-TT₂R₂ score of 3 or more had a larger proportion of patients with poor TTR than those with SAMe-TT₂R₂ score of 2 or less with statistical significance when TTR was below 70% (p=0.03) and 65% (p=0.04), respectively. The discrimination performance of SAMe-TT₂R₂ score was demonstrated with c-statistics of 0.60, 0.59, and 0.55 when TTR was below 70%, 65% and 60%, respectively. Conclusion: Thai AF patients receiving warfarin had a larger proportion of patients with poor TTR when the SAMe-TT₂R₂ score was higher. The score of 3 or more could predict poor quality of anticoagulation control in those patients. Keywords: Time in therapeutic range, Poor quality of anticoagulation control, Warfarin, SAMe-TT₂R₂, Labile INR


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