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[Research progress of femoral bone tunnel positioning in anterior cruciate ligament reconstruction].Zhongguo Xiu Fu Chong Jian Wai Ke Za... Apr 2024To review the concept and methods of femoral bone tunnel positioning in anterior cruciate ligament (ACL) reconstruction, in order to provide a reference for clinical... (Review)
Review
OBJECTIVE
To review the concept and methods of femoral bone tunnel positioning in anterior cruciate ligament (ACL) reconstruction, in order to provide a reference for clinical treatment.
METHODS
The relevant literature on the concept and methods of femoral bone tunnel positioning in ACL reconstruction in domestic and international research was extensively reviewed.
RESULTS
The position of the femoral bone tunnel is a key factor in determining the prognosis of ACL reconstruction. The concept of femoral bone tunnel positioning in ACL reconstruction has experienced isometric reconstruction, anatomical reconstruction, Ribbon-like theory, I.D.E.A.L. theory, and nearly isometric reconstruction theory. The femoral bone tunnel positioning technique is also changing with the in-depth study of the anatomy and biomechanics of the ACL, and each bone tunnel positioning technique has its own advantages and disadvantages. Over-The-Top technique is now mainly used for ACL revision; the clock-face positioning method is basically no longer applicable due to the large error, poor stability, and low retrievability; the bone landmarks positioning method (the lateral condyle of the femur's Resident's ridge and bifurcation ridge, and the the apex of the deep cartilage), which is now mostly used clinically due to the more constant anatomical landmarks. The quadrant method under X-ray fluoroscopy is more cumbersome to implement intraoperatively, so it is mainly used for academic research; computer navigation-assisted positioning has gradually become popular in recent years, which is highly accurate, avoids the influence of human factors on the positioning of the bone tunnel, and has a very good prospect of application; three-dimensional printing-assisted positioning technology, which is accurate in positioning, with a high degree of reproducibility and a short learning curve.
CONCLUSION
The concept of femoral bone tunnel positioning for ACL reconstruction has undergone several evolutions, reflecting the deepening of the understanding of ACL and the improvement of the clinical results of reconstruction. The precision, personalization, and intelligence of positioning techniques are the focus of current and future development.
Topics: Humans; Anterior Cruciate Ligament Injuries; Anterior Cruciate Ligament Reconstruction; Biomechanical Phenomena; Femur; Knee Joint; Reproducibility of Results; Tibia
PubMed: 38632073
DOI: 10.7507/1002-1892.202401121 -
The American Journal of Emergency... Jul 2024Stevens Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are serious conditions that carry a high rate of morbidity and mortality. (Review)
Review
INTRODUCTION
Stevens Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are serious conditions that carry a high rate of morbidity and mortality.
OBJECTIVE
This review highlights the pearls and pitfalls of SJS/TEN, including presentation, diagnosis, and management in the emergency department (ED) based on current evidence.
DISCUSSION
SJS/TEN is a rare, delayed hypersensitivity reaction resulting in de-epithelialization of the skin and mucous membranes. The majority of cases are associated with medication or infection. Clinicians should consider SJS/TEN in any patient presenting with a blistering mucocutaneous eruption. Evaluation of the skin, mucosal, pulmonary, renal, genital, and ocular systems are essential in the diagnosis of SJS/TEN, as well as in the identification of complications (e.g., sepsis). Laboratory and radiological testing cannot confirm the diagnosis in the ED setting, but they may assist in the identification of complications. ED management includes stabilization of airway and breathing, fluid resuscitation, and treatment of any superimposed infections with broad-spectrum antibiotic therapy. All patients with suspected SJS/TEN should be transferred and admitted to a center with burn surgery, critical care, dermatology, and broad specialist availability.
CONCLUSIONS
An understanding of SJS/TEN can assist emergency clinicians in diagnosing and managing this potentially deadly disease.
Topics: Stevens-Johnson Syndrome; Humans; Emergency Service, Hospital; Prevalence
PubMed: 38631147
DOI: 10.1016/j.ajem.2024.04.001 -
Chaos (Woodbury, N.Y.) Apr 2024Built upon the shoulders of graph theory, the field of complex networks has become a central tool for studying real systems across various fields of research....
Built upon the shoulders of graph theory, the field of complex networks has become a central tool for studying real systems across various fields of research. Represented as graphs, different systems can be studied using the same analysis methods, which allows for their comparison. Here, we challenge the widespread idea that graph theory is a universal analysis tool, uniformly applicable to any kind of network data. Instead, we show that many classical graph metrics-including degree, clustering coefficient, and geodesic distance-arise from a common hidden propagation model: the discrete cascade. From this perspective, graph metrics are no longer regarded as combinatorial measures of the graph but as spatiotemporal properties of the network dynamics unfolded at different temporal scales. Once graph theory is seen as a model-based (and not a purely data-driven) analysis tool, we can freely or intentionally replace the discrete cascade by other canonical propagation models and define new network metrics. This opens the opportunity to design-explicitly and transparently-dedicated analyses for different types of real networks by choosing a propagation model that matches their individual constraints. In this way, we take stand that network topology cannot always be abstracted independently from network dynamics but shall be jointly studied, which is key for the interpretability of the analyses. The model-based perspective here proposed serves to integrate into a common context both the classical graph analysis and the more recent network metrics defined in the literature which were, directly or indirectly, inspired by propagation phenomena on networks.
PubMed: 38625080
DOI: 10.1063/5.0202241 -
Zhongguo Zhong Yao Za Zhi = Zhongguo... Mar 2024Traditional Chinese medicine(TCM) syndrome-based efficacy is an evaluation index which is unique to TCM and can reflect the advantages of TCM. The development of the... (Review)
Review
Traditional Chinese medicine(TCM) syndrome-based efficacy is an evaluation index which is unique to TCM and can reflect the advantages of TCM. The development of the methods and measurement tools for evaluating TCM syndrome-based efficacy can provide objective and quantitative evidence for the clinical efficacy evaluation of TCM and the development of new Chinese medicine preparations, being the exploration direction of innovative methods and technologies for evaluating TCM efficacy. The conventional evaluation methods are subjective and limited to the mitigation of symptoms and the improvement of physical signs, which make it difficult to form a unified evaluation standard. In addition, the evaluation methods lack unity, objectivity, and quantitative research. The scientific connotation, evaluation ideas and methods, and key technologies of the evaluation for the therapeutic effect on syndromes remain unclear, which leads to diverse evaluation modes, methods, and indexes. The syndrome-based efficacy scale provides a new idea for the objective quantification and standardization of TCM syndromes. This review systematically summarizes the methods and problems, introduces the research progress in the evaluation scales, and puts forward some thoughts on the characteristics of TCM syndrome-based efficacy evaluation, aiming to provide insights for the research in this field.
Topics: Humans; Medicine, Chinese Traditional; Technology; Syndrome; Drugs, Chinese Herbal
PubMed: 38621930
DOI: 10.19540/j.cnki.cjcmm.20240103.501 -
Harefuah Apr 2024The concept of "successful aging" as coined by Rowe and Kahan in the late nineties of the last century, came to describe a period of old age with multi-functional...
The concept of "successful aging" as coined by Rowe and Kahan in the late nineties of the last century, came to describe a period of old age with multi-functional abilities. The functions are physical, cognitive and social, without progressive chronic diseases and without disabilities. There is a change in the concept of successful aging beyond the physical dimension (daily function (ADL) and cognitive function) which is based on objective performance indicators towards subjective indicators based on the patients' feelings and their quality of life. Successful aging moves from the limited bio-physical aspect to an overall view of bio-psycho-socio which means mental-emotional-behavioral aspects, social involvement, and also an element of spirituality and even end-of-life decisions. Successful aging will be measured by objective and subjective measures that include the patient's feelings and experiences. The idea is to include and see in successful aging not only the absence of morbidity and disability as seen by Rowe and Kahan, but to a multidimensional function that includes physical and cognitive, mental and emotional, social and spiritual parameters and a dimension of the end of life in making decisions according to the wishes and preferences of the person himself and his family.
Topics: Humans; Quality of Life; Cognition; Activities of Daily Living; Aging; Death
PubMed: 38616638
DOI: No ID Found -
JBI Evidence Synthesis Apr 2024The objective of this scoping review is to identify the timings and types of early rehabilitation after spinal cord injuries (SCI) that are documented in the literature,...
OBJECTIVE
The objective of this scoping review is to identify the timings and types of early rehabilitation after spinal cord injuries (SCI) that are documented in the literature, as well as identify possible research gaps in this field.
INTRODUCTION
Preclinical and clinical studies support the idea that early rehabilitation may be beneficial for patients with acute SCI. However, the timing and types of rehabilitation that should and could be used in the acute stage are still unclear. The first step towards such knowledge is to extensively review what is documented in the literature.
INCLUSION CRITERIA
This review will consider all papers focusing on early rehabilitation after SCI in adult humans or animals (<3 months post-SCI for humans and other primates and <3 weeks post-SCI for other animals). Interventions in the included papers must aim at sensorimotor or functional improvement and take place in a hospital or a rehabilitation center if they target human subjects.
METHODS
MEDLINE (PubMed), Scopus, Embase (Embase.com), PEDro, Web of Science Core Collection, CINAHL (EBSCOhost), Cochrane Database of Systematic Reviews, Cochrane CENTRAL, PROSPERO, ClinicalTrials.gov, and gray literature sources will be searched for eligible articles. This review will include published and unpublished experimental and observational studies, research protocols, conference abstracts, systematic reviews, and guidelines. No language or date limits will be applied. Two independent reviewers will perform study selection and data extraction, and the results will be presented according to the SCI type and severity.
REVIEW REGISTRATION
Open Science Framework https://osf.io/q45er.
PubMed: 38602049
DOI: 10.11124/JBIES-22-00461 -
Frontiers in Psychology 2024This is a review of a range of empirical studies that use digital text algorithms to predict and model response patterns from humans to Likert-scale items, using texts... (Review)
Review
This is a review of a range of empirical studies that use digital text algorithms to predict and model response patterns from humans to Likert-scale items, using texts only as inputs. The studies show that statistics used in construct validation is predictable on sample and individual levels, that this happens across languages and cultures, and that the relationship between variables are often semantic instead of empirical. That is, the relationships among variables are given a priori and evidently computable as such. We explain this by replacing the idea of "nomological networks" with "semantic networks" to designate computable relationships between abstract concepts. Understanding constructs as nodes in semantic networks makes it clear why psychological research has produced constant average explained variance at 42% since 1956. Together, these findings shed new light on the formidable capability of human minds to operate with fast and intersubjectively similar semantic processing. Our review identifies a categorical error present in much psychological research, measuring representations instead of the purportedly represented. We discuss how this has grave consequences for the empirical truth in research using traditional psychometric methods.
PubMed: 38577112
DOI: 10.3389/fpsyg.2024.1308098 -
Geriatrie Et Psychologie... Mar 2024Cognitive performance of older adults is very often inferior to that of younger adults on a variety of laboratory tests assessing basic functions such as memory,... (Review)
Review
Cognitive performance of older adults is very often inferior to that of younger adults on a variety of laboratory tests assessing basic functions such as memory, inhibition, or attention. Classic hypotheses and theories share the idea that these cognitive deficits are irreversible, due to profound cerebral changes. In this review article, we develop a more positive conception of aging, according to which cognitive deficits are not all irreversible, and can even be partially if not completely reversible. To this end, we present some of the most illustrative research on the reversibility of the effects of aging on cognition. We show how subtle contextual manipulations can change older adults' motivation and strategy, which improve their cognitive performance. We also show that guidance toward the selection of the most appropriate strategy, whether explicit as in selectivity paradigms or implicit as in dual-task procedures, can increase older adults' cognitive performance. We finally describe the hypotheses and theories that both account for low cognitive performance in old age and ways to reverse the effects of cognitive aging.
Topics: Humans; Aged; Cognition Disorders; Cognitive Dysfunction; Cognition; Cognitive Aging; Aging
PubMed: 38573147
DOI: 10.1684/pnv.2024.1144 -
Die Anaesthesiologie Apr 2024The limitations and disadvantages of opioids in anesthesia are very well known but the advantages combined with a lack of effective alternatives even now still prevents... (Review)
Review
The limitations and disadvantages of opioids in anesthesia are very well known but the advantages combined with a lack of effective alternatives even now still prevents refraining from using opioids as part of an adequate pain therapy. For decades, pain research has had the declared goal of replacing opioids with new substances which have no serious side effects; however, currently this goal seems to be a long way off. Due to the media coverage of the "opioid crisis" in North America, the use of opioids for pain management is also increasingly being questioned by the patients. Measures to contain this crisis are only slowly taking effect in view of the increasing number of deaths, which is why the triggers are still being sought. The perioperative administration of opioids is not only a possible gateway to addiction and abuse but it can also cause outcome-relevant complications, such as respiratory depression, postoperative nausea and vomiting and an increase in postoperative pain. Therefore, these considerations gave rise to the idea of an opioid-free anesthesia (OFA), i.e., opioids are not administered as part of anesthesia to carry out surgical procedures. Although this idea may make sense at first glance, a rapid introduction of this concept appears to be risky as it entails significant changes for the entire anesthesiological management. Based on relatively robust data from clinical studies, this concept can now be evaluated and discussed not only emotionally but also objectively. This review article presents arguments for or against the complete avoidance of intraoperative or even perioperative opioids. The current conditions in Germany are primarily taken into account, so that the perioperative pain therapy is transferable to the established standards. The results from current clinical studies on the implementation of an opioid-free anesthesia are summarized and discussed.
Topics: Humans; Analgesics, Opioid; Anesthesia; Pain Management; Pain, Postoperative; Analgesia
PubMed: 38568253
DOI: 10.1007/s00101-024-01397-2 -
Zhurnal Voprosy Neirokhirurgii Imeni N.... 2024Primary brainstem gliomas are still poorly studied in neurooncology. This concept includes tumors with different histological and genetic features, as well as variable... (Review)
Review
Primary brainstem gliomas are still poorly studied in neurooncology. This concept includes tumors with different histological and genetic features, as well as variable clinical course and outcomes. Nevertheless, treatment implies radiotherapy without a clear idea of morphological substrate of disease in 80% of cases. Small number of studies and insufficient data on histological and genetic nature of brainstem tumors complicate clear diagnostic and treatment algorithms. This review provides current information regarding primary glial brainstem tumors. Appropriate problems and objectives are highlighted. The purpose of the review is to provide a comprehensive and updated understanding of the current state of brainstem glial tumors and to identify areas requiring further study for improvement of diagnosis and treatment of these diseases. Brainstem tumors are an understudied problem with small amount of data that complicates optimal treatment strategies. Further researches and histological verification are required to develop new methods of therapy, especially for diffuse forms of neoplasms.
Topics: Humans; Glioma; Brain Stem Neoplasms
PubMed: 38549416
DOI: 10.17116/neiro20248802198