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Der Orthopade Nov 2020The anterior cruciate ligament (ACL) together with the posterior cruciate ligament is the central stabilizer of the knee. It stabilizes the tibia against increased...
The anterior cruciate ligament (ACL) together with the posterior cruciate ligament is the central stabilizer of the knee. It stabilizes the tibia against increased anterior translation and internal rotation. With an incidence of 46/100,000 ACL tears are among the most common sports injuries in Germany. New prevention programs can reduce the risk of ACL injuries. Surgical treatment is recommended for young and athletic patients as it can also reduce the risk of further relevant injuries of the meniscus and cartilage. The standard of surgical treatment in Germany is the ACL reconstruction with an autologous tendon graft. In selected cases, the preservation of the ACL by arthroscopic refixation shows good results. Instead of the previously used purely time-based rehabilitation, function-based criteria are increasingly being included in the aftercare.
Topics: Adult; Anterior Cruciate Ligament; Anterior Cruciate Ligament Injuries; Anterior Cruciate Ligament Reconstruction; Germany; Humans; Knee Injuries; Knee Joint; Treatment Outcome
PubMed: 33084915
DOI: 10.1007/s00132-020-03997-3 -
Journal Francais D'ophtalmologie Jan 2018Anterior Uveitis is the most common form of uveitis. There are several known and many possible etiologies for anterior uveitis. After examining the posterior segment and... (Review)
Review
Anterior Uveitis is the most common form of uveitis. There are several known and many possible etiologies for anterior uveitis. After examining the posterior segment and ruling out masquerade syndromes, the main step of etiologic diagnosis is clinical characterization. It is essential to establish the presence or absence of unilateral versus bilateral and granulomatous features. Subsequently, a directed work-up may be obtained which then helps to confirm diagnostic hypotheses based on the detailed history and clinical examination. The priority is to rule out an infection. Treatments are adapted according to etiology and disease severity. Finally, biologics have greatly changed the management and prevention of some forms of anterior uveitis, in particular uveitis associated with HLA-B27 and juvenile idiopathic arthritis-associated anterior uveitis.
Topics: Diagnosis, Differential; HLA-B27 Antigen; Humans; Uveitis, Anterior
PubMed: 29290458
DOI: 10.1016/j.jfo.2017.11.003 -
The Bone & Joint Journal Aug 2016Anterior cruciate ligament (ACL) reconstruction is commonly performed and has been for many years. Despite this, the technical details related to ACL anatomy, such as... (Review)
Review
Anterior cruciate ligament (ACL) reconstruction is commonly performed and has been for many years. Despite this, the technical details related to ACL anatomy, such as tunnel placement, are still a topic for debate. In this paper, we introduce the flat ribbon concept of the anatomy of the ACL, and its relevance to clinical practice. Cite this article: Bone Joint J 2016;98-B:1020-6.
Topics: Anterior Cruciate Ligament; Anterior Cruciate Ligament Injuries; Anterior Cruciate Ligament Reconstruction; Biomechanical Phenomena; Femur; Graft Survival; Humans; Range of Motion, Articular; Tibia
PubMed: 27482012
DOI: 10.1302/0301-620X.98B8.37117 -
The Orthopedic Clinics of North America Jan 2020The increasing incidence of anterior cruciate ligament injuries in skeletally immature children demands careful attention by orthopedic surgeons. Assessing skeletal age... (Review)
Review
The increasing incidence of anterior cruciate ligament injuries in skeletally immature children demands careful attention by orthopedic surgeons. Assessing skeletal age is essential to selecting the appropriate reconstruction technique. Males with a bone age of 15 years or older and females of 13 years and older are ideal candidates for a transphyseal anterior cruciate ligament reconstruction because there is minimal risk of growth disturbance. Children with substantial growth remaining (skeletal age males ≤12 years and females ≤10 years) seem to be at risk for more significant growth disturbance, so we generally recommend physeal-sparing techniques for these younger patients.
Topics: Adolescent; Age Determination by Skeleton; Anterior Cruciate Ligament; Anterior Cruciate Ligament Injuries; Anterior Cruciate Ligament Reconstruction; Child; Female; Humans; Knee Injuries; Male; Plastic Surgery Procedures; Treatment Outcome
PubMed: 31739879
DOI: 10.1016/j.ocl.2019.08.009 -
The New England Journal of Medicine Jun 2019
Review
Topics: Adolescent; Anterior Cruciate Ligament; Anterior Cruciate Ligament Injuries; Athletes; Athletic Injuries; Female; Humans; Magnetic Resonance Imaging; Rupture
PubMed: 31189037
DOI: 10.1056/NEJMcp1805931 -
Revista Da Escola de Enfermagem Da U S P Aug 2017Evaluating the occurrence of anxiety in pregnant women and the factors associated with its occurrence; comparing the presence of anxiety in each gestational trimester. (Comparative Study)
Comparative Study
OBJECTIVE
Evaluating the occurrence of anxiety in pregnant women and the factors associated with its occurrence; comparing the presence of anxiety in each gestational trimester.
METHOD
A descriptive, correlational cross-sectional study. Data were collected from January to May 2013 using the Hospital Anxiety Subscale and a form composed of socioeconomic characterization; gestational anamnesis; life-changing habits and events; preexisting conditions and interpersonal relationships.
RESULTS
A total of 209 pregnant women from a municipality in the south of Minas Gerais, Brazil, participated in the study. Anxiety was present in 26.8% of the pregnant women, being more frequent in the third trimester (42.9%). Occupation (p=0.04), complications in previous pregnancies (p=0.00), history of miscarriage risk of preterm birth (p=0.05), maternal desire regarding the pregnancy (p=0.01), number of abortions (p=0.02), number of cigarettes smoked daily (p=0.00) and drug use (p=0.01) were statistically associated with the occurrence of anxiety during pregnancy.
CONCLUSION
Anxiety occurred frequently during pregnancy. Understanding the factors associated with its occurrence allows for elaborating preventive measures in prenatal care.
OBJETIVO
Avaliar a ocorrência da ansiedade em gestantes e os fatores associados à sua ocorrência; comparar a presença de ansiedade em cada trimestre gestacional.
MÉTODO
Estudo descritivo, correlacional, de corte transversal. A coleta de dados ocorreu de janeiro a maio de 2013, utilizou-se da Subescala Hospitalar de Ansiedade e de um formulário composto por caracterização socioeconômica; anamnese gestacional; hábitos e eventos marcantes de vida; patologias preexistentes e relacionamentos interpessoais.
RESULTADOS
Participaram do estudo 209 gestantes de um município do sul de Minas Gerais. A ansiedade esteve presente em 26,8% das gestantes, sendo mais frequente no terceiro trimestre (42,9%). Ocupação (p=0,04), complicações em gestações anteriores (p=0,00), histórico de abortamento/ameaça de parto prematuro (p=0,05), desejo materno em relação à gravidez (p=0,01), número de abortamentos (p=0,02), quantidade de cigarros consumidos diariamente (p=0,00) e uso de drogas (p=0,01) apresentaram associação estatisticamente significativa com a ocorrência da ansiedade na gravidez.
CONCLUSÃO
A ansiedade se mostrou frequente na gestação. O conhecimento dos fatores associados a sua ocorrência oportuniza a elaboração de medidas preventivas na assistência pré-natal.
Topics: Adult; Anxiety; Correlation of Data; Cross-Sectional Studies; Female; Humans; Pregnancy; Pregnancy Complications; Pregnancy Trimesters; Prevalence; Risk Factors; Young Adult
PubMed: 28902327
DOI: 10.1590/S1980-220X2016048003253 -
Journal Francais D'ophtalmologie Feb 2018Anterior uveitis is the most common form of uveitis. There are several known and many possible etiologies for anterior uveitis. After examining the posterior segment and... (Review)
Review
Anterior uveitis is the most common form of uveitis. There are several known and many possible etiologies for anterior uveitis. After examining the posterior segment and ruling out masquerade syndromes, the main step of etiologic diagnosis is clinical characterization. It is essential to establish unilateral versus bilateral involvement and presence or absence of granulomatous features. Subsequently, a work-up may be obtained which then helps to confirm diagnostic hypotheses based on the detailed history and clinical examination. The priority is to rule out an infection, although less frequent, before starting steroid therapy, adapted to the severity of the clinical picture. Finally, biologics have greatly changed the management and prevention of some forms of anterior uveitis, in particular uveitis associated with HLA-B27 and juvenile idiopathic arthritis-associated anterior uveitis.
Topics: Adrenal Cortex Hormones; Arthritis, Juvenile; Diagnosis, Differential; Diagnostic Techniques, Ophthalmological; HLA-B27 Antigen; Humans; Severity of Illness Index; Uveitis, Anterior
PubMed: 29395599
DOI: 10.1016/j.jfo.2017.06.012 -
Revista Latino-americana de Enfermagem Sep 2016to identify and summarize studies examining both drug-drug interactions (DDI) and adverse drug reactions (ADR) in older adults polymedicated. (Review)
Review
OBJECTIVE
to identify and summarize studies examining both drug-drug interactions (DDI) and adverse drug reactions (ADR) in older adults polymedicated.
METHODS
an integrative review of studies published from January 2008 to December 2013, according to inclusion and exclusion criteria, in MEDLINE and EMBASE electronic databases were performed.
RESULTS
forty-seven full-text studies including 14,624,492 older adults (≥ 60 years) were analyzed: 24 (51.1%) concerning ADR, 14 (29.8%) DDI, and 9 studies (19.1%) investigating both DDI and ADR. We found a variety of methodological designs. The reviewed studies reinforced that polypharmacy is a multifactorial process, and predictors and inappropriate prescribing are associated with negative health outcomes, as increasing the frequency and types of ADRs and DDIs involving different drug classes, moreover, some studies show the most successful interventions to optimize prescribing.
CONCLUSIONS
DDI and ADR among older adults continue to be a significant issue in the worldwide. The findings from the studies included in this integrative review, added to the previous reviews, can contribute to the improvement of advanced practices in geriatric nursing, to promote the safety of older patients in polypharmacy. However, more research is needed to elucidate gaps.
OBJETIVO
identificar e sintetizar estudos que examinam as interações medicamentosas (IM) e reações adversas a medicamentos (RAM) em idosos polimedicados.
MÉTODOS
revisão integrativa de estudos publicados de janeiro de 2008 a dezembro de 2013, de acordo com critérios de inclusão e exclusão, nas bases de dados eletrônicas MEDLINE e EMBASE.
RESULTADOS
foram analisados 47 estudos de texto completo, incluindo 14,624,492 idosos (≥ 60 anos): 24 (51,1%) sobre RAM, 14 (29,8%) sobre IM e 9 estudos (19,1%) que investigaram tanto IM como RAM. Encontramos uma variedade de desenhos metodológicos. Os estudos revisados reforçaram que a polifarmácia é um processo multifatorial, e os preditores e a prescrição inadequada estão associados a resultados negativos de saúde, como aumento da frequência e tipos de RAM e IM envolvendo diferentes classes de drogas, além disso, alguns estudos mostram as intervenções mais bem-sucedidas para otimizar a prescrição.
CONCLUSÕES
IM e RAM entre idosos continuam a ser um problema significativo no mundo todo. Os resultados dos estudos incluídos nesta revisão integrativa, adicionado às revisões anteriores, podem contribuir para a melhoria das práticas avançadas de enfermagem geriátrica, para promover a segurança dos pacientes idosos em polifarmácia. No entanto, são necessárias mais pesquisas para elucidar lacunas.
OBJETIVO
identificar y resumir los estudios que analizan tanto las interacciones medicamentosas (IM) como las reacciones adversas a medicamentos (RAM) en los adultos mayores polimedicados.
MÉTODOS
revisión integradora de estudios publicados entre enero de 2008 a diciembre de 2013, siguiendo criterios de inclusión y exclusión, en las bases de datos electrónicas MEDLINE y EMBASE.
RESULTADOS
cuarenta y siete estudios de texto completo incluidos fueron analizados incluyendo 14,624,492 adultos mayores (≥ 60 años), de ellos 24 (51,1%) en relación con RAM, 14 (29,9%) con IM y 9 estudios (19,1%) que investigaron tanto IM como RAM. Encontramos una gran variedad de diseños metodológicos. Los estudios revisados reforzaron el concepto que la polifarmacia es un proceso multifactorial, y los predictores y la prescripción inadecuada se asocian con resultados negativos para la salud tales como el aumento de la frecuencia y tipos de RAM y IM implicando diferentes clases de fármacos, además que algunos estudios muestran cuales son las intervenciones más exitosas para optimizar la prescripción.
CONCLUSIONES
IM y RAM siguen siendo un problema importante en el mundo entero entre los adultos mayores. Los resultados de los estudios incluidos en esta revisión integradora, sumado a las revisiones previas, pueden contribuir a la mejora de las prácticas avanzadas de enfermería geriátrica, para promover la seguridad de los pacientes de mayor edad en la polifarmacia. Sin embargo, se necesita más investigación para esclarecer los vacíos de conocimiento.
Topics: Aged; Drug Interactions; Drug-Related Side Effects and Adverse Reactions; Humans; Middle Aged; Polypharmacy
PubMed: 27598380
DOI: 10.1590/1518-8345.1316.2800 -
Frontiers in Public Health 2023Cytomegalovirus anterior uveitis is the most common ocular inflammatory disease caused by cytomegalovirus infection. It mainly occurs in middle-aged males with competent... (Review)
Review
Cytomegalovirus anterior uveitis is the most common ocular inflammatory disease caused by cytomegalovirus infection. It mainly occurs in middle-aged males with competent immunologic function, and the incidence is higher in Asia. The clinical manifestations vary from Posner-Schlossman syndrome and corneal endotheliitis to Fuchs uveitis syndrome, and are often accompanied by intraocular hypertension. Secondary glaucoma is a potentially blinding ocular complication with a pathogenesis that includes complicated immunological factors, intraocular inflammation, different types of angle abnormalities, and the administration of steroids, which may result in physical discomfort and visual impairment. Diagnostic tests, such as the polymerase chain reaction, optical coherence tomography, ocular microscopy, and confocal microscopy, might help in identifying anterior uveitis caused by other viruses. Combinations of antiviral medications and anti-inflammatory agents are effective treatments. If pharmacological therapy cannot reduce intraocular pressure or slow the progression of glaucomatous optic neuropathy, surgical intervention is required as a last resort.
Topics: Male; Middle Aged; Humans; Cytomegalovirus; Glaucoma; Uveitis, Anterior; Eye; Cytomegalovirus Infections
PubMed: 36935679
DOI: 10.3389/fpubh.2023.1117412 -
Cornea Oct 2022Oleander is a poisonous plant with extensively documented systemic side effects; however, oleander's ophthalmic side effects have not been detailed in the literature. We...
PURPOSE
Oleander is a poisonous plant with extensively documented systemic side effects; however, oleander's ophthalmic side effects have not been detailed in the literature. We report a case of oleander-associated keratitis with subsequent corneal edema and anterior uveitis.
METHODS
This is a case report and review of relevant literature.
RESULTS
A 58-year-old woman presented with large corneal epithelial defect after being struck in the eye with an oleander leaf. Despite treatment with topical moxifloxacin, she developed severe corneal edema and anterior uveitis. A diagnosis of oleander-associated ocular inflammation with secondary corneal edema was made, given the temporal relationship, and treatment was initiated with topical prednisolone and cyclopentolate. However, the corneal edema and inflammation continued to progress until oral prednisone and topical difluprednate were initiated. Visual acuity, anterior uveitis, and corneal edema significantly improved with aggressive immunomodulation. Follow-up at 1 month confirmed complete recovery of symptoms, corneal edema and anterior uveitis.
CONCLUSIONS
Severe corneal edema and anterior uveitis can be associated with oleander exposure. Aggressive treatment with oral and topical steroids may be required without persistent sequelae at the 5-month follow-up. Ophthalmologists should consider this inflammatory reaction if patients experience ocular exposure to oleander.
Topics: Corneal Edema; Cyclopentolate; Female; Humans; Inflammation; Keratitis; Middle Aged; Moxifloxacin; Nerium; Prednisolone; Prednisone; Uveitis, Anterior
PubMed: 36107850
DOI: 10.1097/ICO.0000000000003032