scholarly journals Monopolar and Bipolar Combination Injuries of the Clavicle: Retrospective Incidence Analysis and Proposal of a New Classification System

2021 ◽  
Vol 10 (24) ◽  
pp. 5764
Author(s):  
Mustafa Sinan Bakir ◽  
Roman Carbon ◽  
Axel Ekkernkamp ◽  
Stefan Schulz-Drost
Keyword(s):  
Case Reports ◽  
Clavicle Fracture ◽  
Type I ◽  
Type Ii ◽  
New Classification ◽  
Joint Dislocations ◽  
Type Ia ◽  
Icd 10 ◽  
Bipolar Type ◽  
Incidence Analysis

Clavicle injuries are common, but only few case reports describe combined clavicular injuries (CCI). CCI include combinations between clavicular fractures and acromioclavicular/sternoclavicular joint dislocations (SCJD). We present the first general therapeutic recommendations for CCI based on a new classification and their distribution. A retrospective, epidemiological, big data analysis was based on ICD-10 diagnoses from 2012 to 2014 provided by the German Federal Statistical Office. CCI represent 0.7% of all clavicle-related injuries (n = 814 out of 114,003). SCJD show by far the highest proportion of combination injuries (13.2% of all SCJD were part of CCI) while the proportion of CCI in relation to the other injury entities was significantly less (p < 0.023). CCIs were classified depending on (1) the polarity (monopolar type I, 92.2% versus bipolar type II, 7.8%). Monopolar type I was further differentiated depending on (2) the positional relationship between the combined injuries: Ia two injuries directly at the respective pole versus Ib with an injury at one end plus an additional midshaft clavicle fracture. Type II was further differentiated depending on (3) the injured structures: IIa ligamento-osseous, type IIb purely ligamentous (rarest with 0.6%). According to our classification, the CCI severity increases from type Ia to IIb. CCI are more important than previously believed and seen as an indication for surgery. The exclusion of further, contra-polar injuries in the event of a clavicle injury is clinically relevant and should be focused.

A New Classification for Pathologies of Spinal Meninges, Part 1: Dural Cysts, Dissections, and Ectasias

Neurosurgery ◽  
2017 ◽  
Vol 81 (1) ◽  
pp. 29-44 ◽  
Author(s):  
Jörg Klekamp
Keyword(s):  
Structural Changes ◽  
Long Term Results ◽  
Type I ◽  
Type Ii ◽  
New Classification ◽  
Type Iii ◽  
Dural Sac ◽  
Spinal Cord Herniation ◽  
Dural Defects

Abstract BACKGROUND: The clinical significance of pathologies of the spinal dura is often unclear and their management controversial. OBJECTIVE: To classify spinal dural pathologies analogous to vascular aneurysms, present their symptoms and surgical results. METHODS: Among 1519 patients with spinal space-occupying lesions, 66 patients demonstrated dural pathologies. Neuroradiological and surgical features were reviewed and clinical data analyzed. RESULTS: Saccular dural diverticula (type I, n = 28) caused by defects of both dural layers, dissections between dural layers (type II, n = 29) due to defects of the inner layer, and dural ectasias (type III, n = 9) related to structural changes of the dura were distinguished. For all types, symptoms consisted of local pain followed by signs of radiculopathy or myelopathy, while one patient with dural ectasia presented a low-pressure syndrome and 10 patients with dural dissections additional spinal cord herniation. Type I and type II pathologies required occlusion of their dural defects via extradural (type I) or intradural (type II) approaches. For type III pathologies of the dural sac no surgery was recommended. Favorable results were obtained in all 14 patients with type I and 13 of 15 patients with type II pathologies undergoing surgery. CONCLUSION: The majority of dural pathologies involving root sleeves remain asymptomatic, while those of the dural sac commonly lead to pain and neurological symptoms. Type I and type II pathologies were treated with good long-term results occluding their dural defects, while ectasias of the dural sac (type III) were managed conservatively.

Close Reduction Percutaneous Pinning (CRPP) versus Open Reduction Internal Fixation (ORIF) for Pediatric Supracondylar Humerus Fractures Gartland Type II and III: A Systematic Review and Meta-analysis

2021 ◽  
Vol 71 (4) ◽  
pp. 187-193
Author(s):  
Putu Astawa ◽  
Made Agus Maharjana ◽  
Surya Adisthanaya ◽  
Made Winatra Satya Putra ◽  
Agus Suarjaya Putra ◽  
...  
Keyword(s):  
Systematic Review ◽  
Case Reports ◽  
Meta Analysis ◽  
Fixed Effect Model ◽  
Cosmetic Outcome ◽  
Type I ◽  
Type Ii ◽  
Supracondylar Humerus Fractures ◽  
Significant Difference ◽  
Humerus Fractures

Introduction: Displaced supracondylar fracture in children is a challenging injury that may result in impaired functional and cosmetic outcome if not well-treated. Utilization of Closed Reduction and Percutaneus Pinning (CRPP) increased for this pathology, some authors believe ORIF results better anatomical reduction and lower rate of loss of reduction. Study aims to compare CRPP and ORIF for pediatric supracondylar humerus fracture. Method: Systematic review was conducted based on PRISMA guideline. Inclusion criteria were age <18 years old, comparing CRPP and ORIF for Supracondylar Humerus Fractures Gartland Type II, II.Studies of one surgical technique, Gartland type I, case reports were excluded. For meta-analysis, 6 studies were included and fixed effect model used to pool the result. In each study, mean difference (MD) with 95% confidence interval (CI) was calculated for dichotomous outcomes using Review Manager. Result: Total of 252 patients aged 0-15 years old were included. CRPP more often performed than ORIF. Satisfactory outcomes measured by Flynn’s criteria were achieved in 87.74% in CRPP and 86.73% in ORIF patient group, indicating significant difference (Heterogeneity, I2 = 23%; WMD, 1.26; 0.58 to 2.73; P =0.56). Conclusion: Current systematic review and meta-analysis suggest that for displaced supracondylar humerus fractures, ORIF offers a comparable functional and cosmetic outcome compared to CRPP.

Some large classes of n-valued Sheffer functions

1973 ◽  
Vol 74 (2) ◽  
pp. 201-211 ◽  
Author(s):  
J. C. Muzio
Keyword(s):  
Prime Factor ◽  
Type I ◽  
Type Ii ◽  
Large Classes ◽  
Type Iii ◽  
Type Ia ◽  
Sheffer Function

In 1967, Singer (11) gave 3 classes of n-valued two-place functors and proved that all these functors were Sheffer functions. Out of the n possible assignments needed to define a functor completely, Singer showed that it was sufficient to define 3n − 2, 3n − 2, and 2n assignments respectivelyfor the 3 classes. We shall enlarge Singer's classes to give functors of type Ia, type II and type III. For types Ia and III, it will be shown that it is sufficient to define 2n − 1 assignments and for type II we require 2n − 1 assignments to be defined and conditions on a further n/p1 assignments (where P1 is the least prime factor of n). These classes of functors include all of Singer's classes. We also introduce functors of type Ib, similar to those of type Ia, and show that for these itis sufficient to define 2n − 1 assignments to ensure the functor is a Sheffer function.

Viruslike particles in cells associated with sensilla in head appendages of a dytiscid beetle

1992 ◽  
Vol 70 (1) ◽  
pp. 67-70 ◽  
Author(s):  
R. Y. Zacharuk ◽  
E. S. Leung ◽  
J. C. Jensen
Keyword(s):  
Glial Cells ◽  
Physiological Stress ◽  
Dense Core ◽  
Type I ◽  
Type Ii ◽  
Icosahedral Clusters ◽  
Dense Shell ◽  
Bipolar Type ◽  
Viruslike Particles ◽  
Diving Beetle

Two types of viruslike particles (VLP) were noted in the cytoplasm of cells associated with sensilla on the antennae and labial palps of the diving beetle Graphoderus occidentalis Horn. The most common "hollow" particle was 30–32 nm in diameter with an electron-dense shell about 8 nm thick and, in some cases, a dense core granule about 5.6 nm in diameter. These VLP were always tightly packed in orderly arrays in apparently icosahedral clusters. Such clusters occurred in the perikarya of multiterminal type II neurons and glial cells in the labial nerves, bipolar type I neurons and inner sheath cells of mechano- and chemo-sensilla on both appendages, adjacent epidermal cells, and an axon from an antennal sensillum. A second type of VLP was dense-cored and about 22 nm in diameter. This type was scattered individually or in loose, unordered clusters in a type I sensillar neuron. Both VLP types were closely associated with ribosomes. Some minor cytopathic changes in the contents of cells containing VLP, and the occurrence of VLP as manifestations of physiological stress rather than as infective virions, are discussed.

scholarly journals A New Classification of Anterior Choroidal Artery Aneurysms and Its Clinical Application

2021 ◽  
Vol 13 ◽  
Author(s):  
Yu Duan ◽  
Xuanfeng Qin ◽  
Qinqzhu An ◽  
Yikui Liu ◽  
Jian Li ◽  
...  
Keyword(s):  
Flow Diverter ◽  
Type I ◽  
Type Ii ◽  
Anterior Choroidal Artery ◽  
New Classification ◽  
Class 1 ◽  
Anterior Choroidal ◽  
The Relationship ◽  
Choroidal Artery

Background and Purpose: The aim of this study was to compare the different subtypes of anterior choroidal artery (AChoA) aneurysm based on a new classification and to analyze the risk factors according to individual endovascular treatment (EVT).Methods: In the new classification, AChoA aneurysms are classified into independent type (I type) and dependent type (II type) based on the relationship between the AChoA and the aneurysm. II type aneurysms have three subtypes, IIa (neck), IIb (body), and IIc (direct). We retrospectively analyzed 52 cases of AChoA aneurysm treated in our center between 2015 to 2019. There were 13 (25.0%) I type aneurysms, 24 (46.2%) IIa aneurysms, 15 (28.8%) IIb aneurysms, and no IIc type; 28 cases had a subarachnoid hemorrhage. According to our preoperative EVT plan for the different subtypes: II type should achieve Raymond-Roy Occlusion Class 1 (RROC 1) where possible. To protect the AChoA, it is best to preserve the neck of the IIa type aneurysms (RROC 2), and RROC 3 is enough for IIb type.Results: Ten asymptomatic cases with minimal aneurysms were treated conservatively. Of the other cases, 42 were treated with individualized EVT (26 with a simple coil, 6 with balloon-assisted coiling, 7 with stent-assisted coiling, and 3 by flow diverter. Different subtypes had different RROC (Z = 14.026, P = 0.001). IIb type aneurysms (χ2 = 7.54, P = 0.023) were one of the factors related to temporary or permanent AChoA injury during surgery. Overall, two patients (IIa = 1, IIb = 1) developed contralateral hemiparesis.Conclusions: The new classification diagram clearly shows the features of all types of AChoA aneurysm and makes EVT planning more explicit. The II type (particularly IIb) was a potential risk factor for AChoA injury.

scholarly journals Allergy Associated Myocardial Infarction: A Comprehensive Report of Clinical Presentation, Diagnosis and Management of Kounis Syndrome

Vaccines ◽  
2021 ◽  
Vol 10 (1) ◽  
pp. 38
Author(s):  
Anastasios Roumeliotis ◽  
Periklis Davlouros ◽  
Maria Anastasopoulou ◽  
Grigorios Tsigkas ◽  
Ioanna Koniari ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Coronary Arteries ◽  
Case Reports ◽  
Type I ◽  
Type Ii ◽  
Kounis Syndrome ◽  
Normal Coronary Arteries ◽  
St Segment Elevation ◽  
Type Iii ◽  
Coronary Syndrome

Kounis syndrome (KS) has been defined as acute coronary syndrome (ACS) in the context of a hypersensitivity reaction. Patients may present with normal coronary arteries (Type I), established coronary artery disease (Type II) or in-stent thrombosis and restenosis (Type III). We searched PubMed until 1 January 2020 for KS case reports. Patients with age <18 years, non-coronary vascular manifestations or without an established diagnosis were excluded. Information regarding patient demographics, medical history, presentation, allergic reaction trigger, angiography, laboratory values and management were extracted from every report. The data were pulled in a combined dataset. From 288 patients with KS, 57.6% had Type I, 24.7% Type II and 6.6% Type III, while 11.1% could not be classified. The mean age was 54.1 years and 70.6% were male. Most presented with a combination of cardiac and allergic symptoms, with medication being the most common trigger. Electrocardiographically, 75.1% had ST segment elevation with only 3.3% demonstrating no abnormalities. Coronary imaging was available in 84.8% of the patients, showing occlusive lesions (32.5%), vascular spasm (16.2%) or normal coronary arteries (51.3%). Revascularization was pursued in 29.4% of the cases. In conclusion, allergic reactions may be complicated by ACS. KS should be considered in the differential diagnosis of myocardial infarction with non-obstructive coronary arteries.

scholarly journals A New Classification of Talocalcaneal Coalitions Based On Computed Tomography For Operative Planning

2021 ◽  
Author(s):  
Anhong Wang ◽  
Weili Shi ◽  
Linxin Chen ◽  
Xing Xie ◽  
Feng Zhao ◽  
...  
Keyword(s):  
Classification System ◽  
Subtalar Joint ◽  
Type I ◽  
Type Ii ◽  
New Classification ◽  
Type Iv ◽  
Talocalcaneal Coalition ◽  
Operative Planning ◽  
Accessory Ossicle

Abstract Background Current classifications emphasize the morphology of the coalition, however, subtalar joint facets involved should also be emphasized.Objective The objective of this study was to develop a new classification system based on the articular facets involved to cover all coalitions and guide operative planning.Methods Patients were diagnosed with talocalcaneal coalition using a CT scan, between January 2009 and February 2021. We classified the coalition into four main types according to the shape and nature of the coalition: I, inferiorly overgrown talus or superiorly overgrown calcaneus; II, both talus and calcaneus overgrew; III, coalition with an accessory ossicle; (I-III types are non-osseous coalition) IV, complete osseous coalition. Then each type was further divided into three subtypes according to the articular facets involved. A, the coalition involving the anterior facets; M, the coalition involving the middle facets, and P, the coalition involving the posterior facets.Results There were 106 patients (108 feet) included in this study. Overall, 8 feet (7.5%) were classified as type I, 75 feet (69.4%) as type II, 7 feet (6.5%) as type III, and 18 feet (16.7%) as type IV. Twenty-nine coalitions (26.9%) involved the posterior facets only (subtype-P), 74 coalitions (68.5%) involved both the middle and posterior facets (subtype-MP), and five coalitions (4.6%) simultaneously involved the anterior, middle, and posterior facets (subtype-AMP). Type II-MP coalition was the most common.Conclusion A new classification system of the talocalcaneal coalition to facilitate operative planning was developed.

scholarly journals Agreement between results of meta-analyses from case reports and clinical studies, regarding efficacy and safety of idursulfase therapy in patients with mucopolysaccharidosis type II (MPS-II). A new tool for evidence-based medicine in rare diseases

2019 ◽  
Vol 14 (1) ◽  
Author(s):  
Miguel Sampayo-Cordero ◽  
Bernat Miguel-Huguet ◽  
Almudena Pardo-Mateos ◽  
Andrea Malfettone ◽  
José Pérez-García ◽  
...  
Keyword(s):  
Rare Diseases ◽  
Clinical Studies ◽  
Case Reports ◽  
Meta Analysis ◽  
Type I ◽  
Mucopolysaccharidosis Type ◽  
Type Ii ◽  
Mucopolysaccharidosis Type Ii ◽  
Mps Ii ◽  
Meta Analyses

Abstract Background A preliminary exploratory study shows solid agreement between the results of case reports and clinical study meta-analyses in mucopolysaccharidosis Type I (MPS-I) adult patients. The aim of the present study is to confirm previous results in another patient population, suffering from mucopolysaccharidosis Type II (MPS-II). Methods A systematic review and meta-analysis of case reports published by April 2018 was conducted for MPS-II patients treated with enzyme replacement therapy (ERT). The study is reported in accordance with PRISMA and MOOSE guidelines (PROSPERO database code CRD42018093408). The assessed population and outcomes were the same as previously analyzed in a meta-analysis of MPS-II clinical studies. The primary endpoint was the percent of clinical cases showing improvement in efficacy outcome, or no harm in safety outcome after ERT initiation. A restrictive procedure to aggregate case reports, by selecting standardized and well-defined outcomes, was proposed. Different sensitivity analyses were able to evaluate the robustness of results. Results Every outcome classified as “acceptable evidence group” in our case report meta-analysis had been graded as “moderate strength of evidence” in the aforementioned meta-analysis of clinical studies. Sensitivity, specificity, and positive-negative predictive values for results of both meta-analyses reached 100%, and were deemed equivalent. Conclusions Aggregating case reports quantitatively, rather than analyzing them qualitatively, may improve conclusions in rare diseases and personalized medicine. Additionally, we propose some methods to evaluate publication bias and heterogeneity of the included studies in a meta-analysis of case reports.

scholarly journals A new ultrasound and clinical classification for management of prostatic abscess

2015 ◽  
Vol 87 (3) ◽  
pp. 246 ◽  
Author(s):  
Lucio Dell’Atti
Keyword(s):  
Ultrasound Imaging ◽  
Case Reports ◽  
Published Data ◽  
Type I ◽  
New Classification ◽  
Prostatic Abscess ◽  
Type Iv ◽  
Type V ◽  
Sonographic Pattern

Objectives: In literature, most of the published data regarding prostatic abscess (PA) are case reports, whereas there is no standardization of the diagnostic and therapeutic routines. The purpose of this study is a new classification of ultrasound imaging of PA with clinical features correlation. Material and Methods: We retrospectively analysed the ultrasound database archives and performed a MEDLINE<sup>®</sup> research of the peer reviewed literature on diagnosis and case reports of PA using the terms “prostate and abscess”. Results: PA can be classified into five Types: Type I - PA is present focally in a prostate lobe (≤ 10 mm). Type II - PA is present in a prostate lobe (&gt; 10 mm) and/or partially overcrosses the border of the midline prostatic glandular. Type III - PA is present in both glandular lobes form of multifocal areas (≤ 10 mm). Type IV - PA is present in both glandular lobes form of multifocal areas (&gt; 10 mm). Type V - PA involving intra or extraprostatic structures (bladder, urethra, seminal vesicles and prostatic capsule). The different ultrasound imaging and diagnostic criteria are listed for each type and subtype. Conclusions: The sonographic pattern of PA is usually characteristic and easily differentiated from other glandular lesions. The purpose of the study was to associate the use of TRUS to a clinical standardized classification in order to facilitate PA diagnosis and localization directing the clinician treatment to the correct management and adequate therapeutic treatment.

Sign in / Sign up

Export Citation Format

Share Document