Survivorship Rate and Clinical Outcomes 10 Years After Arthroscopic Correction of Symptomatic Femoroacetabular Impingement

Background: Femoroacetabular impingement (FAI) is a common mechanical hip condition, prevalent in both the athletic and the general population. Surgical intervention is an effective treatment option that improves both symptoms and function in short- to medium-term follow-up. Few studies within the literature have reported the longer-term success of arthroscopic surgery. Purpose: The aim of this study was to quantify the 10-year survivorship and clinical outcome for patients treated arthroscopically for symptomatic FAI. Study Design: Case series; Level of evidence, 4. Methods: Patients from our hip registry (n = 119) completed patient-reported outcome measures (PROMs) including the modified Harris Hip Score (mHHS), University of California Los Angeles (UCLA) activity scale, 36-Item Short Form Health Survey (SF-36), and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) at a minimum of 10 years after arthroscopy (range, 10-12 years). Results were compared with baseline scores using the Wilcoxon signed rank test. The associations among several prognostic factors, which included age, sex, Tönnis grade, and labral treatment, and subsequent conversion to total hip replacement (THR) or repeat hip arthroscopy (RHA) were analyzed using the chi-square analysis. Relationships between range of motion and radiological findings with clinical outcome were also examined using Pearson correlation analysis. Minimal clinically important difference (MCID) was calculated using a distribution method (0.5 standard deviation of the change score), and substantial clinical benefit (SCB) was determined using an anchor method. Finally, receiver operating characteristic curves with subsequent Youden index were used to determine cutoffs for PROMs, which equated to a Patient Acceptable Symptom State (PASS). Results: A total of 8.4% of cases required conversion to THR, and 5.9% required RHA. Statistically significant improvements in mHHS, SF-36, and WOMAC scores, with high satisfaction (90%), were observed 10 years after surgery. No significant change was seen in activity level (UCLA score) despite patients being 10 years older. A high percentage of patients achieved MCID for mHHS (88%), SF-36 (84%), and WOMAC (60%). The majority of patients also achieved PASS (62% for mHHS, 85% for UCLA, 78% for SF-36, and 84% for WOMAC) and SCB (74% for mHHS, 58% for UCLA, 52% for SF-36, and 56% for WOMAC). Conclusion: Arthroscopic intervention is a safe and viable treatment option for patients with symptomatic FAI, and patients can expect long-term improvements and high satisfaction. Results indicated a high satisfaction (90%) and survivorship rate (91.6%), with excellent clinical outcome, 10 years after the initial procedure.

Skills for Fitting Models to Data

The chapter “Skills for Fitting Models to Data” provides worked examples of the model parameter estimation and model-selection examples presented in Part 2, both in spreadsheets and in R. This chapter presumes that the reader is reasonably comfortable setting up spreadsheets and R code and applying the modeling skills presented in Chapter 15. It begins with maximum likelihood estimation, presenting first a direct method and then numerical methods that yield more precise (usually) estimates of maximum likelihood parameter estimates. It then examines how to estimate parameters that do not appear in probability functions (e.g. a model in which survivorship rate is density dependent). The chapter concludes by discussing likelihood profiles.

Seasonal demography of the threatened Montevideo Redbelly Toad (Melanophryniscus montevidensis) in a protected area of Uruguay

Estimates of demographic parameters are scarce for Neotropical amphibians, a concerning fact because this region has the highest proportion of threatened amphibians in the world. We conducted a 3-year study where we applied a robust capture–mark–recapture design to assess the importance of breeding and non-breeding activity patterns over the survival rates, detection probabilities, and abundances of the Montevideo Redbelly Toad (Melanophryniscus montevidensis (Philippi, 1902)), a threatened anuran from Uruguay. The best models grouped seasons into hot and cold periods cyclically, were state-dependent in transition probabilities, and were time-dependent in detection probabilities for adults, but had constant detection probabilities for juveniles. Averaged estimates suggest a high survivorship rate during cold seasons (above 80%), but lower probabilities (below 60%) during hot seasons, especially for males. Analogously, the non-breeding activity had a seasonal pattern, with higher activity during spring and higher sheltering rates during autumn. These activity rates negatively influenced the averaged survivorship rates of adult males and females. Long-term (matrix) projections of seasonal survivorships, along with assessments of the causes of these patterns, should be carried out to determine extinction probabilities and possible threats for the conservation of the genus Melanophryniscus.

The relationship between the pituitary somatotrophic function and the immune system, its role in the development of neoplasia

The present review is focused on the relationship between growth hormone (GH) production and the state of the immune system. The influence of growth factors on the population and subpopulation composition of CD-expressing lymphocytes, functional activity of immune cells, and apoptosis is discussed. The detailed description of the role of disturbances in the pituitary somatotrophic function and the concomitant immune disorders is presented with special reference to the development of neoplastic processes. Changes in the immune system of the patients with chronic hypersecretion of growth factors are described. Tight interactions between the immune and endocrine systems appear to greatly contribute to tumour pathogenesis and have direct effect on the survivorship rate among the patients with acromegaly.

Different pathways in the larval development of the crab Ucides cordatus (Decapoda, Ocypodidae) and their relation with high mortality rates by the end of massive larvicultures

One of the most limiting factors affecting the larval rearing of Ucides cordatus in the laboratory is a period of high mortality, which usually occurs late in the course of the larviculture during the metamorphosis from the zoeal to the megalopal phase. The objective of the present research was to analyze the post-embryonic development of U. cordatus on an individual basis and, in particular, to search for patterns linking disturbances in the molting process to the high larval death rates observed in massive larvicultures. A total of 50 larvae were individually reared from hatching to metamorphosis into the megalopal phase under controlled conditions, fed a combination of microalgae and rotifers. The survivorship rate was 70% until zoea V. The 35 surviving zoea V larvae followed two different pathways. Eleven underwent metamorphosis directly to megalopa, eighteen molted to zoea VI and six died as zoea V. In the last molting event, only two zoea VI larvae reached the megalopal stage, while the remaining sixteen died. In further observation under microscope, 13 of the dead zoea VI showed characteristics of the pre-molt stage and pereiopods disproportionably large in relation to the carapace. The observed pattern resembles the Molt Death Syndrome (MDS) described for other decapod species, in which larvae die in the late pre-molt phase of the molting cycle. We suggest that U. cordatus larvae develop disturbances in the molting process similar to the MDS described for other species and that these disturbances are related to a more complex pathway involving the emergence of larval stage zoea VI.

Low reproductive success of Campo Suiriri (Suiriri affinis) and Chapada Flycatcher (S. islerorum) in the central Brazilian Cerrado

We investigated the reproductive success of Campo Suiriri (Suiriri affinis) and Chapada Flycatcher (S. islerorum) in the Estação Ecológica de Águas Emendadas, Central Brazil. Between June and December 2003, we monitored 25 nests of Campo Suiriri and 20 nests of Chapada Flycatcher. The simple percentage of successful nests was 32% for Campo Suiriri and 10% for Chapada Flycatcher, whereas the reproductive success calculated by the Mayfield method was 19% for Campo Suiriri and 14% for Chapada Flycatcher. The estimated values of daily survivorship rate (DSR) for Campo Suiriri are as follows: egg period 0.971 and nestling period 0.944. For Chapada Flycatcher the figures were 0.964 and 0.930, respectively. No differences in DSRs between species or periods were statistically significant. All nest losses of Campo Suiriri were due to predation, while for Chapada Flycatcher predation accounted for 78% of nest losses and the remaining 22% was due to parasitism by botfly larvae (Philornis sp.). The low reproductive success of Chapada Flycatcher is close to the lowest values recorded for Neotropical birds and might be a threat to this species and an important variable in the determination of its conservation status.