Tag: pubmed

J Phys Ther Sci. 2021 Apr;33(4):345-350. doi: 10.1589/jpts.33.345. Epub 2021 Apr 6.

ABSTRACT

[Purpose] In Japan, the government issued a state of emergency due to the spread of COVID-19 in April 2020. In this study, we measured physical activity before and after the state of emergency, and assessed the factors that affected physical activity. [Participants and Methods] We included thirteen elderly people living in Hiroshima Prefecture, Japan, in the study. The participants wore 3-axis accelerometer on their hips to measure physical activity for a week, before (in October 2019) and after the state of emergency. According to the median rate of decrease in physical activity (23.6%), we divided the participants into two groups: one group had participants with a high rate of decrease (low physical activity) and the other had participants with a low rate of decrease (high physical activity). [Results] The following factors decreased after the state of emergency: total physical activity, amount of moderate-intensity physical activity and activities of daily living, amount of light-intensity physical activity and walking, daily activity time, and daily steps. Statistical analysis showed that engaging in housework was associated with high physical activity. [Conclusion] Elderly people who engaged in household chores had a smaller decrease in physical activity. In order to reduce the decrease in physical activity and the risk of cardiovascular events, the elderly should perform as many daily activities and hobbies as they can while paying attention to the infection control measures.

PMID:33935359 | PMC:PMC8079888 | DOI:10.1589/jpts.33.345

Rev Bras Ortop (Sao Paulo). 2021 Apr;56(2):251-255. doi: 10.1055/s-0040-1721832. Epub 2021 Mar 31.

ABSTRACT

Objective The present study aims to identify the energy required for synthetic proximal femoral fracture after removal of three implant types: cannulated screws, dynamic hip screws (DHS), and proximal femoral nail (PFN). Methods Twenty-five synthetic proximal femur bones were used: 10 were kept intact as the control group (CG), 5 were submitted to the placement and removal of 3 cannulated screws in an inverted triangle configuration (CSG), 5 were submitted to the placement and removal of a dynamic compression screw (DHSG), and 5 were submitted to the placement and removal of a proximal femur nail (PFNG). All samples were biomechanically analyzed simulating a fall on the greater trochanter using a servo-hydraulic machine to determine the energy (in Joules [J]) required for fracture. Results All samples presented basicervical fractures. The energy required for fracture was 7.1 J, 6.6 J, 6 J, and 6.7 J for the CG, CSG, DHSG and PFNG, respectively. There was no statistically significant difference (considering a 95% confidence interval) in energy among the study groups ( p = 0.34). Conclusion There was no statistically significant difference in the energy required to cause a synthetic proximal femoral fracture after removing all three implant types and simulating a fall over the greater trochanter.

PMID:33935322 | PMC:PMC8075645 | DOI:10.1055/s-0040-1721832

Scientometrics. 2021 Apr 26:1-8. doi: 10.1007/s11192-021-03961-8. Online ahead of print.

ABSTRACT

The h-index is an indicator of the scientific impact of an academic publishing career. Its hybrid publishing/citation nature and inherent bias against younger researchers, women, people in low resourced countries, and those not prioritizing publishing arguably give it little value for most formal and informal research evaluations. Nevertheless, it is well-known by academics, used in some promotion decisions, and is prominent in bibliometric databases, such as Google Scholar. In the context of this apparent conflict, it is important to understand researchers’ attitudes towards the h-index. This article used public tweets in English to analyse how scholars discuss the h-index in public: is it mentioned, are tweets about it positive or negative, and has interest decreased since its shortcomings were exposed? The January 2021 Twitter Academic Research initiative was harnessed to download all English tweets mentioning the h-index from the 2006 start of Twitter until the end of 2020. The results showed a constantly increasing number of tweets. Whilst the most popular tweets unapologetically used the h-index as an indicator of research performance, 28.5% of tweets were critical of its simplistic nature and others joked about it (8%). The results suggest that interest in the h-index is still increasing online despite scientists willing to evaluate the h-index in public tending to be critical. Nevertheless, in limited situations it may be effective at succinctly conveying the message that a researcher has had a successful publishing career.

PMID:33935333 | PMC:PMC8072298 | DOI:10.1007/s11192-021-03961-8

Surg Laparosc Endosc Percutan Tech. 2021 May 3. doi: 10.1097/SLE.0000000000000940. Online ahead of print.

ABSTRACT

BACKGROUND: Endoscopic submucosal dissection (ESD), as a minimally invasive procedure for removal of early gastrointestinal neoplasms, is a standard approach in Asian countries. Outcomes of ESD in Western European countries significantly differ, which makes it more difficult to apply this procedure to daily-basis clinical routine. The aim of this study is to analyze the safety and efficiency of colorectal ESD based on a large series of cases performed by a single operator after finishing the learning curve period in a western referral center.

MATERIALS AND METHODS: We retrospectively studied 601 patients who underwent ESD procedure for colorectal neoplasm from January 2016 to December 2019 in a tertiary colorectal ESD center in Poland.

RESULTS: The overall en bloc resection was achieved in 88.02%. Complete histologic resection rate (R0) was reported at a level of 86.36%. Lesions located in the right colon were characterized by statistically lower en bloc, R0 resection, and success rate (73.95%, 71.43%, 69.75%, respectively). In 9.82% (n=59) of cases, the ESD procedure-related complications have been observed. Post-ESD bleeding occurred in 23 patients (3.83%) and perforation in 32 patients (5.32%). Twenty-seven patients were treated endoscopically (4.49%) and 5 required surgery (0.83%). Analysis of complications showed that tumors located within the right colon were characterized by the highest perforation rate at 10.92%. Within the rectum there were minimal number of perforations (2.69%), whereas the bleeding rate was 4.48%.

CONCLUSIONS: Our results represent the largest material concerning ESD of colorectal lesions in the West and show that ESD is characterized by a high rate of successful resections with a low risk of complications. Thus, confirming that it is possible to obtain results similar to Asian centers and that colorectal ESD procedures can be implemented in clinical routine in western countries. Nevertheless, ESD in the right colon is still related with high rate of complications, so qualification for the ESD procedure should be very careful and discussed with the patient and should be performed by an experienced endoscopist after the learning curve.

PMID:33935259 | DOI:10.1097/SLE.0000000000000940

Rev Bras Ortop (Sao Paulo). 2021 Apr;56(2):230-234. doi: 10.1055/s-0040-1722578. Epub 2021 Mar 31.

ABSTRACT

Objectives The present study aims to identify preoperative characteristics of the patient, of the injury, as well as of imaging, which would point towards a type IV fracture. The present study shall help the operating team to predict more accurately the type IV pattern preoperatively, leading to improved counselling of the caregivers, planning of surgery, as well as preparedness regarding open reduction, if such situation arises. Methods A retrospective study was conducted, including patients that met the following criteria: 1) age < 16 years old; 2) Gartland type-III and type-IV supracondylar fractures; and 3) with complete records. Demographic data like age, gender, laterality, mode of injury, hospital duration of the injury, history of previous attempts of closed reduction, open/closed fracture, distal neurovascular status, and radiographic data like angulation, translation, osseous apposition and fracture comminution were collected. Results Hospital duration of the injury and previous attempts of closed reduction were the factors that had a statistically significant difference among types III and IV fractures ( p < 0.05). A diagnosis of type IV supracondylar fractures was significantly more likely in the presence of valgus angulation of the distal fragment ≥ 17° (odds ratio [OR] = 20.22; 95% confidence interval [CI] = 3.45-118.65). Flexion angulation ≥ 10° (OR = 5.32; 95% CI = 0.24-119.88) of the distal fragment predicted Gartland type IV with a sensitivity of 41% and a specificity of 100%. Conclusion The preoperative evaluation of suspected Gartland IV fractures can help the operating surgeon in predicting such injuries. Nonradiographic factors like increased hospital duration of the injury, attempts at previously closed reduction, and radiographic parameters like valgus and flexion angulation were more likely to be associated with type IV fractures. Level of evidence III.

PMID:33935319 | PMC:PMC8075635 | DOI:10.1055/s-0040-1722578

J Knee Surg. 2021 May 1. doi: 10.1055/s-0041-1729621. Online ahead of print.

ABSTRACT

The purpose of the current randomized clinical trial (RCT) was to evaluate the clinical outcomes of combined anterior cruciate ligament (ACL) and anterolateral ligament (ALL) reconstruction and to compare them with those of isolated ACL reconstruction. The hypothesis was that combined ACL and ALL reconstruction will result in superior clinical outcomes in terms of the rotational stability of the knee. This prospective RCT included 57 patients (44 men and 13 women, mean age = 31 ± 7.1 years) who underwent ACL reconstruction either isolated (Group I: 25 patients) or combined with ALL reconstruction (Group II: 32 patients). The evaluation of the patients was done preoperatively and postoperatively at 6 weeks, 12 weeks, 6 months, and 12 months including a clinical examination (Lachman’s test, Pivot shift’s test, and Rolimeter differential anterior laxity), an objective clinical scores (objective: the International Knee Documentation Committee [IKDC] score) and a subjective clinical scores (subjective: IKDC’s score, Lysholm’s score, and Tegner’s activity score). Postoperative complications of all the patients were recorded. There was a significant difference between the study groups at all follow-up intervals when evaluating the postoperative pivot shift test (p < 0.05) with a superior rotational stability in the group of combined ACL and ALL reconstruction. At the final follow-up evaluation, 36% of the patients from Group I and 6.2% in Group II had a grade I positive pivot shift test (p < 0.05). There was a statistically significant difference between the two groups regarding the number of patients with a grade A IKDC objective score (p < 0.05) at the 6- and 12-month follow-up intervals (p = 0.007). There was a significant difference concerning the IKDC subjective score between the two study groups in favor of the combined ACL and ALL reconstruction group at 12 months postoperatively (p = 0.048). Combined ACL and ALL reconstruction technique was demonstrated to be effective in obtaining a superior control of the rotational knee instability and to improve the clinical objective and subjective outcomes when compared with isolated ACL reconstruction in sports patients with high-grade pivoting shifts.

PMID:33932949 | DOI:10.1055/s-0041-1729621

J Knee Surg. 2021 May 1. doi: 10.1055/s-0041-1729553. Online ahead of print.

ABSTRACT

The purpose of this study was to determine if driving ability 6 weeks after anterior cruciate ligament (ACL) reconstruction is affected by the addition of a meniscal suture. It was also hypothesized that no differences in the driving performance would be found between right or left knee surgery subgroups. A total of 82 people participated in this prospective cohort study: 36 healthy controls, 26 patients undergoing isolated ACL (iACL) reconstruction with hamstring autograft, and 20 patients undergoing ACL and meniscal suture (ACL-MS) reconstruction. ACL-MS group followed a weight-bearing and movement restriction protocol during the first 2 postoperative weeks, whereas patients undergoing iACL could start range-of-motion exercises and full weight-bearing ambulation on the first postoperative day. A driving simulator that reproduced real-life driving conditions was used to evaluate driving ability. The software analyzed multiple driving and braking variables. Driving performance in the sixth postoperative week was compared with that of a healthy control group. Subgroup analysis considering additional procedures (iACL, ACL-MS) and the side of the operated knee (right, left) was also performed. No statistically significant differences were found in the demographic characteristics nor in the driving performance (collisions, p = 0.897; sidewalk invasions, p = 0.749; pedestrian impact, p = 0.983) between iACL, ACL-MS, and control groups. No statistically significant differences were found in right-left subgroup analysis. The results of the present study show that patients in their sixth postoperative week after right or left ACL reconstruction showed similar driving performance as compared with a healthy control group, regardless of associating or not a meniscal suture, suggesting it is safe to resume driving 6 weeks after the mentioned surgeries.

PMID:33932951 | DOI:10.1055/s-0041-1729553

Neurosurg Focus. 2021 May;50(5):E15. doi: 10.3171/2021.2.FOCUS201097.

ABSTRACT

OBJECTIVE: Separation surgery followed by spine stereotactic radiosurgery (SSRS) has been shown to achieve favorable rates of local tumor control and patient-reported outcomes in patients with metastatic epidural spinal cord compression (MESCC). However, rates and factors associated with adjacent-level tumor progression (ALTP) in this population have not yet been characterized. The present study aimed to identify factors associated with ALTP and examine its association with overall survival (OS) in patients receiving surgery followed by radiosurgery for MESCC.

METHODS: Thirty-nine patients who underwent separation surgery followed by SSRS for MESCC were identified using a prospectively collected database and were retrospectively reviewed. Radiological measurements were collected from preoperative, postoperative, and post-SSRS MRI. Statistical analysis was conducted using the Kaplan-Meier product-limit method and Cox proportional hazards test. Subgroup analysis was conducted for patients who experienced ALTP into the epidural space (ALTP-E).

RESULTS: The authors’ cohort included 39 patients with a median OS of 14.7 months (range 2.07-96.3 months). ALTP was observed in 16 patients (41.0%) at a mean of 6.1 ± 5.4 months postradiosurgery, of whom 4 patients (10.3%) experienced ALTP-E. Patients with ALTP had shorter OS (13.0 vs 17.1 months, p = 0.047) compared with those without ALTP. Factors associated with an increased likelihood of ALTP included the amount of bone marrow infiltrated by tumor at the index level, amount of residual epidural disease following separation surgery, and prior receipt of radiotherapy at the index level (p < 0.05). Subgroup analysis revealed that primary tumor type, amount of preoperative epidural disease, time elapsed between surgery and radiosurgery, and prior receipt of radiotherapy at the index level were significantly associated with ALTP-E (p < 0.05).

CONCLUSIONS: To the authors’ knowledge, this study is the first to identify possible risk factors for ALTP, and they suggest that it may be associated with shorter OS in patients receiving surgery followed by radiosurgery for MESCC. Future studies with higher power should be conducted to further characterize factors associated with ALTP in this population.

PMID:33932922 | DOI:10.3171/2021.2.FOCUS201097

Neurosurg Focus. 2021 May;50(5):E16. doi: 10.3171/2021.2.FOCUS201091.

ABSTRACT

OBJECTIVE: Oncological resection of primary spine tumors is associated with lower recurrence rates. However, even in the most experienced hands, the execution of a meticulously drafted plan sometimes fails. The objectives of this study were to determine how successful surgical teams are at achieving planned surgical margins and how successful surgeons are in intraoperatively assessing tumor margins. The secondary objective was to identify factors associated with successful execution of planned resection.

METHODS: The Primary Tumor Research and Outcomes Network (PTRON) is a multicenter international prospective registry for the management of primary tumors of the spine. Using this registry, the authors compared 1) the planned surgical margin and 2) the intraoperative assessment of the margin by the surgeon with the postoperative assessment of the margin by the pathologist. Univariate analysis was used to assess whether factors such as histology, size, location, previous radiotherapy, and revision surgery were associated with successful execution of the planned margins.

RESULTS: Three hundred patients were included. The surgical plan was successfully achieved in 224 (74.7%) patients. The surgeon correctly assessed the intraoperative margins, as reported in the final assessment by the pathologist, in 239 (79.7%) patients. On univariate analysis, no factor had a statistically significant influence on successful achievement of planned margins.

CONCLUSIONS: In high-volume cancer centers around the world, planned surgical margins can be achieved in approximately 75% of cases. The morbidity of the proposed intervention must be balanced with the expected success rate in order to optimize patient management and surgical decision-making.

PMID:33932923 | DOI:10.3171/2021.2.FOCUS201091

Neurosurg Focus. 2021 May;50(5):E9. doi: 10.3171/2021.1.FOCUS20671.

ABSTRACT

OBJECTIVE: Survival of cancer patients continues to improve with systemic treatment advancements, leading to an increase in cancer-related complications such as pathological spinal fractures. In this study, the authors aimed to evaluate the outcome of percutaneous stabilization with cement augmentation of the pedicle screws in the management of patients with metastatic cancer to the spine.

METHODS: The authors reviewed a retrospective case series of 74 patients with symptomatic pathological spine fractures treated with cement-augmented pedicle screws implanted with a percutaneous technique. The mean imaging follow-up was 11.3 months. Data on demographics, clinical outcomes, and complications were collected. Cement extravasation, spinal hardware integrity, and fusion rates were assessed on CT scans.

RESULTS: Among 50 patients with follow-up imaging, 23 patients (46%) showed facet joint fusion. The length of segmental stabilization was not a significant predictor of the occurrence of fusion. Pre- or postoperative radiation therapy, postoperative chemotherapy, and the location of spinal lesions did not have a statistically significant effect on the occurrence of fusion. Patients older than 60 years of age were more likely to have fusion across facet joints compared with younger patients. There was a significant difference in the mean visual analog scale pain score, with 6.28 preoperatively and 3.41 postoperatively, regardless of fusion status (p < 0.001). Cement extravasation was seen in 51% of the cohort, but in all instances, patients remained asymptomatic. Most importantly, the incidence of hardware failure was low (4%).

CONCLUSIONS: Percutaneous fixation with cement-augmented pedicle screws in patients with pathological spine fractures provides an improvement in mechanical back pain, with a low incidence of failure, and in some patients, spontaneous facet fusion was observed. Further research is necessary with regard to both short-term benefits and long-term outcomes.

PMID:33932939 | DOI:10.3171/2021.1.FOCUS20671