scholarly journals Reluxation Rates Following Different Techniques for Open Stabilisation of Feline Coxofemoral Dislocations

2019 ◽  
Vol 4 (1) ◽  
Author(s):  
Elly Russell
Keyword(s):  
Open Access ◽  
Surgical Technique ◽  
Open Reduction ◽  
Small Sample ◽  
Insufficient Evidence ◽  
Short Term ◽  
Bottom Line ◽  
Exclusion Criteria ◽  
Small Sample Sizes

<p><strong>PICO question</strong></p><p>In cats with craniodorsal coxofemoral luxation does surgical stabilisation using a toggle rod technique result in a lower rate of reluxation than using a transarticular pin?</p><p><strong>Clinical bottom line</strong></p><p>There is currently insufficient evidence to identify if transarticular pinning or a toggle rod technique result in lower rates of reluxation following surgical management of craniodorsal coxofemoral luxations in cats.</p><p>Both transarticular pinning and toggling using the Arthrex Mini TightRope system with Arthrex FiberWire suture resulted in 0% reluxation rates at short-term radiographic follow up with 0/20 joints reluxated at 2–6 weeks post-transarticular pinning and 0/4 joints reluxated at 6 weeks post-toggling.</p><p>Toggling using an IMEX toggle (IMEX Veterinary Inc.) and polydioxanone (PDS II, Ethicon) suture had a higher reluxation rate of 14% (2/14 joints) at 3.5 to 6 weeks postsurgery.</p><p>Longer term follow up of joints stabilised using transarticular pinning found 16.6% reluxation (2/13 joints) when radiographed at least 6 months after surgery.</p><p>Small sample sizes, and variations in the length of follow up, inclusion and exclusion criteria and surgical technique significantly challenges any conclusions that may be drawn.</p><p>It does appear that reluxation rates for all three techniques investigated here compare favourably to generally quoted reluxation rates following open reduction (28% quoted by Rochereau et al., 2012) and that the use of all reported techniques can be justified for the management of craniodorsal coxofemoral luxations in cats.</p><br /> <img src="https://www.veterinaryevidence.org/rcvskmod/icons/oa-icon.jpg" alt="Open Access" /> <img src="https://www.veterinaryevidence.org/rcvskmod/icons/pr-icon.jpg" alt="Peer Reviewed" />

scholarly journals An evaluation of the use of ronidazole for the treatment of Tritrichomonas foetus in cats

2019 ◽  
Vol 4 (4) ◽  
Author(s):  
Genever Bethan Morgan
Keyword(s):  
Dose Range ◽  
Clinical Signs ◽  
Case Series ◽  
Small Sample ◽  
Tritrichomonas Foetus ◽  
Bottom Line ◽  
Successful Resolution ◽  
Small Sample Sizes ◽  
Randomised Controlled

PICO question In cats infected with Tritrichomonas foetus, does treatment with oral ronidazole compared to an alternative antiprotozoal treatment or placebo result in successful resolution of clinical signs and eradication of disease? Clinical bottom line Ronidazole use appears to be efficacious in eradicating infection with Tritrichomonas foetus and resolving diarrhoea associated with infection. A dose range of 30–50 mg/kg 12–24 hourly has been suggested, with evidence suggesting that a dose of 30 mg/kg 24 hourly for 14 days may be effective. However, some cats may require higher doses and some may not respond to treatment, and relapse may occur during a protracted period following completion of the treatment course. Neurological side effects appear to be uncommon but may occur with doses of 30 mg/kg and above. A total of six studies are reviewed: Three randomised, controlled studies, one cohort study and two case series (one retrospective). Findings indicate efficacy of ronidazole treatment in eradicating infection and resolving diarrhoea, however many studies involved small sample sizes and limited follow-up. Therefore, evidence to support the use of ronidazole in Tritrichomonas foetus infected cats remains relatively limited.  

scholarly journals Endoscopically controlled surgery with open hemilaminectomy for the treatment of intradural extramedullary tumors: an operative technique and short-term outcomes of 20 consecutive cases

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Xiaorong Yan ◽  
Huiqing Wang ◽  
Cai Li ◽  
Yuanxiang Lin ◽  
Lin Lin ◽  
...  
Keyword(s):  
Surgical Technique ◽  
Spinal Deformity ◽  
Tumor Recurrence ◽  
Clinical Symptoms ◽  
Short Term ◽  
Before And After ◽  
Intradural Extramedullary ◽  
Controlled Surgery

Abstract Background To present a surgical technique for the treatment of intradural extramedullary (IDEM) tumors by using endoscopically controlled surgery with open hemilaminectomy technique. Methods In this study, 20 patients with 22 IDEM tumors were enrolled. An endoscopically controlled surgery with open hemilaminectomy was employed to remove the tumors. Data related to clinical symptoms and medical images before and after surgery were collected for perioperative evaluation and follow-up analysis. Results All the tumors in 20 patients were well removed. The clinical symptoms were significantly reduced in all the patients as well. The short-term follow-up data showed that there was no tumor recurrence or spinal deformity. Conclusion The endoscopically controlled surgery with open hemilaminectomy technique provided favorable exposure and satisfactory resection to the IDEM tumors. It may be an effective surgical method for treating IDEM tumors. Larger samples and longer follow-up data are needed to verify its long-term effectiveness.

scholarly journals Cannabis and breastfeeding

2020 ◽  
Vol 25 (Supplement_1) ◽  
pp. S26-S28 ◽  
Author(s):  
Lisa Graves
Keyword(s):  
Health Care Providers ◽  
Small Sample ◽  
Adverse Outcomes ◽  
Care Providers ◽  
High Quality ◽  
High Quality Evidence ◽  
Small Sample Sizes ◽  
The Impact ◽  
Quality Evidence

Abstract Cannabis is one of the most commonly used substances in Canada with 15% of Canadians reporting use in 2019. There is emerging evidence that cannabis is linked to an impact on the developing brain in utero and adverse outcomes in infants, children, and adolescents. The impact of cannabis during breastfeeding has been limited by studies with small sample sizes, follow-up limited to 1 year and the challenge of separating prenatal exposure from that during breastfeeding. In the absence of high-quality evidence, health care providers need to continue to engage women in conversation about the potential concerns related to breastfeeding and cannabis use.

scholarly journals Endoscopically-controlled surgery with open hemi-laminectomy for the treatment of intradural extramedullary tumors: An operative technique and short-term outcomes of 20 consecutive cases

2020 ◽  
Author(s):  
Xiaorong Yan ◽  
Huiqing Wang ◽  
Cai Li ◽  
Yuanxiang Lin ◽  
Lin Lin ◽  
...  
Keyword(s):  
Surgical Technique ◽  
Spinal Deformity ◽  
Tumor Recurrence ◽  
Clinical Symptoms ◽  
Short Term ◽  
Before And After ◽  
Intradural Extramedullary ◽  
Controlled Surgery

Abstract Background To present a surgical technique for the treatment of intradural extramedullary (IDEM) tumors by using endoscopically-controlled surgery with open hemi-laminectomy technique. Methods In this study, 20 patients with 22 IDEM tumors were enrolled. An endoscopically-controlled surgery with open hemi-laminectomy was employed to remove the tumors. Data related to clinical symptoms and medical images before and after surgery were collected for perioperative evaluation and follow-up analysis. Results All the tumors in 20 patients were well removed. The clinical symptoms were significantly reduced in all the patients as well. The short term follow-up data showed that there was no tumor recurrence or spinal deformity. Conclusion The endoscopically-controlled surgery with open hemi-laminectomy technique provided favorable exposure and satisfactory resection to the IDEM tumors. It may be an effective surgical method for treating IDEM tumors. Larger samples and longer follow-up data are needed to verify its long-term effectiveness.

scholarly journals A Prospective Study on Treatment of Distal Radial Fractures Using Volar Locking Plate

2020 ◽  
Vol 3 (1) ◽  
Keyword(s):  
Internal Fixation ◽  
Distal Radius ◽  
Open Reduction ◽  
Locking Plate ◽  
Small Sample ◽  
Care Hospital ◽  
Volar Locking Plate ◽  
Distal Radial Fractures ◽  
Compression Plating

Introduction: Distal radius fractures are one of the most common injuries which come to the orthopaedic surgeons. Displaced extra-or intra-articular fractures require anatomical reduction for a good outcome. Historically, these fractures were treated with manipulation and casting, with or without Kirschner (K) wire fixation. Modern plating techniques have been advocated to restore anatomical alignment and allow early mobilisation. Despite the wide variety of treatment options available there is still debate about the best way to treat these fractures. The aim of this study was to evaluate fifty cases of fracture distal end radius treated by open reduction and internal fixation using locking compression plating (LCP). Methods: The present study was carried out on 50 cases of acute fracture distal radius admitted at a tertiary care hospital treated by open reduction and internal fixation using locking compression plating (LCP) between January 2018 and December 2018. Functional results were rated at the end of the study as excellent, good or poor as criteria laid down by Gartland and Werley’s combined subjective and objective criteria. Results: 50 cases of fracture distal radius were selected for study that fulfill the inclusion criteria, were operated and studied. 10 fractures were fixed using Extra-articular Locking Compression T-Plates, 40 fractures were fixed using Juxtaarticular Locking Compression T-Plates. According to the Gartland and Werley’s rating scale, 20 had excellent results, 23 good results, and 07 fair results during latest follow up. Conclusion: Notwithstanding a very small sample size and a short follow up, Volar locking plate osteosynthesis at the distal radius signifies a significant improvement in the treatment of distal radial fractures in terms of restoration of the shape and function of the wrist.

scholarly journals Are We There Yet? Immersive Virtual Reality to Improve Cognitive Function in Dementia and Mild Cognitive Impairment

2019 ◽  
Vol 60 (7) ◽  
pp. e502-e512 ◽  
Author(s):  
Meelad Sayma ◽  
Remco Tuijt ◽  
Claudia Cooper ◽  
Kate Walters
Keyword(s):  
Virtual Reality ◽  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Small Sample ◽  
Cognitively Impaired ◽  
Immersive Virtual Reality ◽  
Exclusion Criteria ◽  
Registration Number ◽  
Small Sample Sizes ◽  
Design And Methods

Abstract Background and Objectives Cognitive training therapies may delay cognitive deterioration in dementia. There is potential to enhance delivery through immersive virtual reality (IVR), as removing potential distractors for cognitively impaired individuals can enhance their experience, resulting in increased engagement. Evidence in this field is emerging and not yet synthesized. We aimed to summarize research investigating the use of IVR in dementia to evaluate the current extent of use, acceptability, feasibility, and potential effectiveness. We also aimed to identify gaps in current research and to create a set of recommendations in utilizing this therapy. Research Design and Methods A systematic literature review was conducted. Our review was registered with PROSPERO, registration number: CRD42019122295. We undertook searches of five databases, article references, and citations. Key authors in the field of health care VR were also contacted to identify additional papers. Articles were assessed for inclusion by two researchers independently. Data were extracted using standardized forms. Results Our search identified a total of 2,824 citations, following screening for duplicates and application of inclusion and exclusion criteria, five studies were included for analysis. Included studies were heterogeneous, with small sample sizes and mixed outcomes. Discussion and Implications We were unable to reach definitive conclusions over the use, acceptability, and effectiveness of IVR for dementia and mild cognitive impairment. Future studies should focus on ensuring their interventions are truly immersive, developing more robust controls and account for the rapid rate of obsolescence in digital technologies.

scholarly journals A Gluten Free Diet in the Management of Epilepsy in People with Coeliac Disease or Gluten Sensitivity

2020 ◽  
Vol 2 (3) ◽  
pp. 281-299
Author(s):  
Zoë Gilbey ◽  
Justine Bold
Keyword(s):  
Coeliac Disease ◽  
Small Sample ◽  
Gluten Free Diet ◽  
Gluten Sensitivity ◽  
Gluten Free ◽  
Exclusion Criteria ◽  
Search Terms ◽  
Small Sample Sizes ◽  
Eeg Pattern

The aim of this review was to assess the effects of a gluten free diet (GFD) in the management of epilepsy in people with coeliac disease (CD) or gluten sensitivity (GS). A systematic approach was used to undertake a literature review. Five electronic databases (PubMed; Scopus; Google Scholar; Cochrane Epilepsy Group specialised register; Cochrane Register of Controlled Trails (CENTRAL) via the Cochrane Register of Online Trials) were searched using predetermined relevant search terms. In total, 668 articles were identified. Duplicates were removed and predefined inclusion and exclusion criteria were applied, and a PRISMA flow chart was produced. Data was extracted using Covidence software. Twelve studies on Epilepsy and CD involving a total of 70 participants were selected for analysis; narrative synthesis was used owing to the small sample sizes in the selected studies. None of the 12 studies meeting inclusion criteria investigated gluten sensitivity and epilepsy. All the included studies support a link between epilepsy and CD. GFD was effective in 44 out of 70 participants across the studies in terms of a reduction of seizures, reduction of antiepileptic drugs (AEDs) or normalisation of EEG pattern. A total of 44 participants showed a reduction in seizures (across eight studies) and complete cessation of seizures was reported in 22 participants. In general, the earlier the GFD is implemented after the onset of seizures, the better the likelihood of the GFD being successful in supporting control of seizures. Mechanisms linking gluten with epilepsy are not fully understood; possible hypotheses include gluten mediated toxicity, immune-induced cortical damage and malabsorption. Evidence suggests the effectiveness of a GFD in supporting the management of epilepsy in patients with CD, although the quality of evidence is low. There appears to be a growing number of neurologists who are prepared to advocate the use of a GFD. A multidisciplinary approaches and further research are recommended. It could be argued that when balancing potential treatments such as AEDs or surgery, a GFD has a low likelihood of harm.

scholarly journals EROSITA: AGN SCIENCE, BACKGROUND DETERMINATION, AND OPTICAL FOLLOW-UP SPECTROSCOPY

2013 ◽  
Vol 53 (A) ◽  
pp. 793-798
Author(s):  
Thomas Boller
Keyword(s):  
Small Sample ◽  
Scientific Success ◽  
X Ray ◽  
Photometric Redshift ◽  
Sky Survey ◽  
Extended Sources ◽  
Small Sample Sizes ◽  
Primary Instrument ◽  
The Ideal

More than 20 years after the highly impacting ROSAT all-sky survey in the soft X-ray spectral range, we are close to the next major X-ray all/sky surveys with eROSITA. eROSITA will be the primary instrument on-board the Russian “Spectrum–Roentgen–Gamma” (SRG) satellite which will be launched from Baikonur in 2014 and placed in an L2 orbit. It will perform the first imaging all-sky survey in the medium energy X-ray range up to 10 keV with an unprecedented spectral and angular resolution. The eROSITA all sky X-ray survey will take place in a very different context than the ROSAT survey. There is now a wealth of complete, ongoing and planned surveys of the sky in broad range of wavelengths from the gamma, X-ray to the radio. A significant amount of science can be accomplished through the multi-frequency study of the eROSITA AGN and cluster sample, including optical confirmation and photometric redshift estimation of the eROSITA extended sources and AGNs. Optical spectroscopy has been, and will for the foreseeable future be, one of the main tools of astrophysics allowing studies of a large variety of astronomical objects over many fields of research. The fully capitalize on the eROSITA potential, a dedicated spectroscopic follow-up program is needed. 4MOST is the ideal instrument to secure the scientific success of the eROSITA X-ray survey and to overcome the small sample sizes together with selection biases that plagued past samples. The aim is to have the instrument commissioned in 2017, well matched to the data releases of eROSITA and Gaia. The design and implementation of the 4MOST facility simulator aimed to optimize the science output for eROSITA is described in necessary details.

Predictors of Mid- to Long-Term Outcomes in Patients Experiencing a Knee Dislocation: A Systematic Review of Clinical Studies

2021 ◽  
Author(s):  
John-Rudolph H. Smith ◽  
John W. Belk ◽  
Jamie L. Friedman ◽  
Jason L. Dragoo ◽  
Rachel M. Frank ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Clinical Outcomes ◽  
Clinical Studies ◽  
Small Sample ◽  
Cochrane Library ◽  
Long Term Outcomes ◽  
Short Term ◽  
Female Sex

AbstractKnee dislocations (KDs) are devastating injuries for patients and present complex challenges for orthopaedic surgeons. Although short-term outcomes have been studied, there are few long-term outcomes of these injuries available in the literature. The purpose of this study is to determine factors that influence mid- to long-term clinical outcomes following surgical treatment of KD. A review of the current literature was performed by searching PubMed, the Cochrane Library, and Embase to identify clinical studies published from 2010 to 2019 with a minimum 2-year follow-up that reported outcomes following surgical treatment of KDs. Ten studies (6 level III, 4 level IV) were included. At mid- (2–10 y) to long-term (>10 y) follow-up, concomitant arterial, cartilage, and combined meniscus damage were predictive factors for inferior Lysholm and International Knee Documentation Committee (IKDC) scores when compared with patients without these associated injuries. Although concomitant neurological damage may influence short-term outcomes due to decreased mobility, at longer follow-up periods it does not appear to predict worse clinical outcomes when compared with patients without concomitant neurological injury. Frank and polytrauma KDs have been associated with worse mid- to long-term outcomes when compared with transient and isolated KDs. Patients who underwent surgery within 6 weeks of trauma experienced better long-term outcomes than those who underwent surgery longer than 6 weeks after the initial injury. However, the small sample size of this study makes it difficult to make valid recommendations. Lastly, female sex, patients older than 30 years at the time of injury and a body mass index (BMI) greater than 35 kg/m2 are factors that have been associated with worse mid- to long-term Lysholm and IKDC scores. The results of this review suggest that female sex, age >30 years, BMI >35 kg/m2, concomitant cartilage damage, combined medial and lateral meniscal damage, KDs that do not spontaneously relocate, and KDs associated with polytrauma may predict worse results at mid- to long-term follow-up.

Patients undergoing hip arthroscopy with active workers’ compensation claims do not demonstrate inferior outcomes at mid-term

2018 ◽  
Vol 29 (5) ◽  
pp. 543-549
Author(s):  
Itay Perets ◽  
Dan Prat ◽  
Mary R. Close ◽  
Edwin O Chaharbakhshi ◽  
Stephanie M Rabe ◽  
...  
Keyword(s):  
Hip Arthroscopy ◽  
Patient Reported Outcomes ◽  
Workers Compensation ◽  
Inclusion Criteria ◽  
Short Term ◽  
Exclusion Criteria ◽  
Patient Reported ◽  
Compensation Claims ◽  
Labral Pathology

Introduction: Workers’ compensation (WC) claims have been associated with poor short-term outcomes after hip arthroscopy. We aim to report mid-term outcomes and return to work (RTW) among patients with WC claims. Methods: Data were prospectively collected and retrospectively reviewed for patients undergoing hip arthroscopy between September 2008 and July 2011. Inclusion criteria were an active WC claim at time of surgery with preoperatively-documented patient-reported outcomes (PROs). Exclusion criteria were a previous hip condition and preoperative Tönnis grade >1. Patient-reported WC cases were pair-matched to non-WC cases based on body mass index (BMI) ± 5, age ± 5 years, gender, preoperative LCEA, labral treatment, and capsular treatment. Results: 52 patients had minimum 5-year outcomes. Mean age was 40.6 (±10.6) years and a mean BMI of 27.5 (±5.3). 9 (16.7%) hips underwent secondary arthroscopies. 5 hips (9.3%) were converted to THA. There were 5 (9.3%) reports of numbness, all of which resolved spontaneously. Work status details were available for 49 patients and 47 patients (95.9%) returned to work. 42 WC hips were matched to 42 control hips. At ⩾5-year follow-up, patient-reported outcomes, visual analogue scale (VAS) and satisfaction were not different between the groups. All magnitudes in improvement were significantly higher in the WC group ( p = < 0.001) except for VAS. No significant differences were found in rates of secondary arthroscopies, conversions to THA, or complications between the groups. Conclusions: WC patients have equal favourable mid-term outcomes as non-WC patients after hip arthroscopy for the treatment of femoroacetabular impingement and labral pathology.

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