-
Arthroplasty Today Jun 2024Successful total hip arthroplasty (THA) relies on the correct implant position. THA accuracy can be improved with the use of intraoperative fluoroscopic-assisted...
BACKGROUND
Successful total hip arthroplasty (THA) relies on the correct implant position. THA accuracy can be improved with the use of intraoperative fluoroscopic-assisted computer navigation. Artificial intelligence (AI) software may enhance fluoroscopic navigation; however, the accuracy of the AI compared to human-controlled software in assessing acetabular component position and leg length discrepancy (LLD) has not been studied.
METHODS
We analyzed 420 consecutive primary THAs performed by a single surgeon using fluoroscopic-assisted computer navigation software. The first cohort of 211 patients required inputs from a human technician (manual), while the second cohort of 209 patients used an automated version of the software controlled by AI. The intraoperative acetabular component placement (inclination and anteversion) and LLD were recorded and compared to the 2-week postoperative standing anterior-posterior pelvis radiograph.
RESULTS
Ninety-four percent (199/211) of cups in the manual cohort and 95% (198/209) of cups in the AI cohort were within the Lewinnek "safe-zone" ( = 1.0). In the manual cohort, 69% (146/211) of THAs had a final LLD within ±2 mm of the intraoperatively navigated LLD (ie, ΔLLD ≤2 mm). In the AI cohort, 66% (137/209) of THAs had a final LLD within ±2 mm of the intraoperatively navigated LLD ( = .47). Ninety-nine percent (209/211) of hips in the manual cohort and 98% (205/209) of hips in the AI cohort had a final LLD within ±5 mm of the intraoperatively navigated LLD ( = .45).
CONCLUSIONS
Both AI and human-controlled versions of the same navigation platform were similarly accurate for navigating cup position within the Lewinnek "safe zone" and LLD accuracy.
PubMed: 38840694
DOI: 10.1016/j.artd.2024.101410 -
Angiology Jun 2024Substantial advances occurred in phlebological practice in the last two decades. With the use of modern diagnostic equipment, the patients' venous hemodynamics can be... (Review)
Review
Substantial advances occurred in phlebological practice in the last two decades. With the use of modern diagnostic equipment, the patients' venous hemodynamics can be examined in detail in everyday practice. Application of venous segments for arterial bypasses motivated studies on the effect of hemodynamic load on the venous wall. New animal models have been developed to study hemodynamic effects on the venous system. In vivo and in vitro studies revealed cellular phase transitions of venous endothelial, smooth muscle, and fibroblastic cells and changes in connective tissue composition, under hemodynamic load and at different locations of the chronically diseased venous system. This review is an attempt to integrate our knowledge from epidemiology, paleoanthropology and anthropology, clinical and experimental hemodynamic studies, histology, cell physiology, cell pathology, and molecular biology on the complex of this frequent disease. Our conclusion is that the disease is initiated by limited genetic adaptation of mankind not to bipedalism but to bipedalism in the unmoving standing or sitting position. In the course of the disease several pathologic vicious circles emerge, sustained venous hypertension inducing cellular phase transitions, chronic wall inflammation, apoptosis of cells, pathologic dilation, and valvular damage which, in turn, further aggravate the venous hypertension.
PubMed: 38839285
DOI: 10.1177/00033197241256680 -
World Neurosurgery Jun 2024To evaluate the efficacy, safety of patient-tailored 3D printed brace in the treatment of adolescent idiopathic scoliosis (AIS), and to compare the health-related...
OBJECTIVE
To evaluate the efficacy, safety of patient-tailored 3D printed brace in the treatment of adolescent idiopathic scoliosis (AIS), and to compare the health-related quality of life (HRQoL) of patients treated with two different types of brace.
MATERIALS AND METHODS
From September 2017 to August 2020, 103 AIS patients requiring non-operative management were prospectively recruited in this study. All patients were followed up every 6 months, clinical and radiological examination were assessed at each follow-up time. Full-length anteroposterior X-ray of the spine in the standing position was performed obtained. At the last follow-up, each patient completed a standardized HRQoL questionnaire. Compliance is defined as that the patient insists on wearing the brace for ≥ 23h every day (full-time wearing) and follow-up every 6 months until bone maturity.The rate of major curve Cobb progression was defined that maximum Cobb Angle of major curve greater than 6° compared with that at the initial diagnosis, or aggravated to more than 45° so that orthopedic surgery was recommended during treatment, which was defined as the rate of conversion to surgery. The effects of these two types of braces on the rate of major curve Cobb progression and HRQoL were analyzed by independent sample t-test ad Chi-square test.
RESULTS
The thickness was 4 mm for thoracolumbosacral orthosis (TLSO) and 3 mm for 3D-printed brace (3DPB). In addition, compared with the material used in TLSO, the weight (600-800 grams) of the 3DPB materials with the same area is reduced by about 25-30%. 55 patients (49.1%) and 48 patients (33.1%) were respectively included in the 3DPB cohort and the TLSO cohort.The maximum Cobb angle of major curve in the 3DPB cohort was significantly lower than those in the TLSO cohort at 6 months, 12 months and the last follow-up (p < 0.01). The thoracic kyphosis (TK) and lumbar lordosis (LL) of the two cohorts at the last follow-up were lower than those before brace treatment, in addition, there was a significant difference in TK (p = 0.001) and LL (p = 0.004) between the two cohorts at the follow-up. The scores of physical function, pain, self-image, mental health and treatment satisfaction in the Chinese version of SRS-22 in the 3DPB cohort were higher than those in the TLSO cohort (p < 0.01 and p < 0.05, respectively). The scores of the 3DPB cohort were significantly higher than those of the TLSO group in the four dimensions (p = 0.008, 0.013, 0.015, and 0.002, respectively) of the EuroQol-5D health description system except for mobility, and the overall health status of EuroQol-5D was higher for the 3DPB cohort (p < 0.001). At the last follow-up, One patient in the 3DPB cohort and ten patients in the TLSO cohort had major curve Cobb progression of greater than 6°, and the rate of major curve Cobb progression in 3DPB cohort was significantly lower than that in the TLSO cohort (OR 14.2, 95% CI 1.7∼115.8, p < 0.01). One patient in the 3DPB and seven patients in the TLSO cohorts received subsequent surgery or was recommended for surgery, and the rate of conversion to surgery was significantly lower than in the 3DPB cohort (OR 9.2, 95% CI 1.1∼77.9, p < 0.05).
CONCLUSIONS
Patient-tailored 3D-printed brace is lighter, thinner, and more comfortable than conventional braces in the treatment of AIS. It can substantially improve the HRQoL of patients and can significantly reduce the progression of major curve Cobb progression and rate of conversion of surgery.
PubMed: 38838937
DOI: 10.1016/j.wneu.2024.05.165 -
Advances in Therapy Jul 2024Sagittal sequences of the spine have been shown to correlate with knee osteoarthritis (KOA), but coronal sequences and KOA have never been studied before. The study... (Observational Study)
Observational Study
INTRODUCTION
Sagittal sequences of the spine have been shown to correlate with knee osteoarthritis (KOA), but coronal sequences and KOA have never been studied before. The study required patients to use a standard standing posture and aimed to explore the relationship between coronal position of lumbar spine and WOMAC score in KOA.
METHODS
This is a cross-sectional observational study. Data on a total of 268 patients with KOA were collected. Patients were photographed in a standard standing position and lumbar-sacrum offset distance (L-SOD) and lumbar-knee offset distance (ΔL-KOD) were calculated. Patients were then divided into different groups according to different critical values and differences were compared.
RESULTS
In the L-SOD of L1-3, WOMAC function (P = 0.021, P = 0.032, P = 0.001) and total score (P = 0.039, P = 0.034, P < 0.001) were different. In the L-SOD of L3-4, WOMAC pain score were different (P = 0.001, P = 0.032). At a cutoff of 13 mm, ΔL-KOD of L1-2 showed significant differences in pain part (P = 0.025, P = 0.039) and total score (P = 0.036, P = 0.050). There were significant differences in pain (P = 0.023, P = 0.027, P = 0.022), function (P = 0.048, P = 0.038, P = 0.047), and total score (P = 0.030, P = 0.027, P = 0.029) of L3-5. In the 18-mm cutoff group, only L1 and L2 have differences in the pain part (P = 0.050, P = 0.038).
CONCLUSION
Coronal balance of the lumbar spine is associated with knee pain and function. The pelvis plays an important role in maintaining the coronal balance. Both the lumbar spine and the knee joint should be considered when developing the surgical strategy.
Topics: Humans; Osteoarthritis, Knee; Cross-Sectional Studies; Male; Female; Middle Aged; Lumbar Vertebrae; Aged; Standing Position; Pain Measurement; Severity of Illness Index
PubMed: 38833141
DOI: 10.1007/s12325-024-02898-7 -
Journal of Physical Therapy Science Jun 2024[Purpose] The intensity of active recovery (AR) for performance recovery is often determined using breath gas analyzers and other special equipment. However, such...
[Purpose] The intensity of active recovery (AR) for performance recovery is often determined using breath gas analyzers and other special equipment. However, such procedures are difficult to perform in the field or where facilities are inadequate. Although several AR methods using simple patient-derived information have been proposed, only a few have specifically addressed their immediate effects. The present study aimed to quantify the immediate effects of AR, which was determined using the maximum exercise capacity calculated using a physical fitness test without specialized devices. [Participants and Methods] Thirty-two healthy male participants were equally divided into AR and control groups. Each group performed squat jumps, followed by a recovery intervention of jogging at a set intensity in the AR group or rest in a seated position in the control group. Standing long jumps performed before and after the squat jumps as well as after the intervention were analyzed. [Results] The recovery rate for standing long jumps was significantly higher in the AR group than in the control group. [Conclusion] The results of this pilot study indicate that the implementation of AR based on maximum exercise capacity may enhance performance recovery and requires further validation in larger studies.
PubMed: 38832220
DOI: 10.1589/jpts.36.337 -
Gait & Posture May 2024Multi-segment foot models have been used to quantify foot kinematics during walking. However, walking kinematics is not sufficient to assess hindfoot flexibility...
BACKGROUND
Multi-segment foot models have been used to quantify foot kinematics during walking. However, walking kinematics is not sufficient to assess hindfoot flexibility (available range of hindfoot varus-valgus motion). The modified Shriners Hospitals for Children - Greenville (mSHCG) foot model has been used to quantify hindfoot flexibility with Coleman block test (peak hindfoot valgus) and Root test (peak hindfoot varus). Sensitivity of mSHCG foot model to detect clinically relevant difference in hindfoot flexibility measures for planovalgus (PV) and cavovarus (CV) feet has not been demonstrated.
RESEARCH QUESTION
Can mSHCG foot model detect statistically significant difference in hindfoot flexibility measures between PV, CV and typically developing (TD) feet?
METHODS
Hindfoot flexibility assessment was completed for 32 PV (37 feet), 27 CV (37 feet) and 20 TD (40 feet) individuals. Hindfoot position relative to tibia in coronal plane was measured in three postures: standing, heel raise and Coleman block test. Radiographic measures in standing position were also completed for PV and CV individuals and their correlation with hindfoot flexibility measures were evaluated.
RESULTS
Statistically significant (p<0.001) differences were observed between three groups (TD, PV, CV) in all three hindfoot flexibility measures- (i) Hindfoot varus in standing position (ii) Peak hindfoot varus in heel raise and (iii) Peak hindfoot valgus in Coleman block test. There was relatively stronger correlation (R=0.407-0.854) between three radiographic measures and hindfoot varus in standing position. Correlation between hindfoot range of motion towards valgus from standing to Coleman block test and the three radiographic measures was weaker (R=0.2329-0.3042).
SIGNIFICANCE
Hindfoot flexibility assessment can detect statistically significant difference between PV, CV and TD feet and provides additional information about available dynamic range of motion of hindfoot in the coronal plane that cannot be predicted from radiographic measures. Therefore, hindfoot flexibility assessment may assist in treatment planning of foot deformities.
PubMed: 38823334
DOI: 10.1016/j.gaitpost.2024.05.031 -
Journal of Translational Medicine May 2024Dizziness and vertigo rank among the top 10 reasons for emergency and clinical referrals to neurologists. Chronic dizziness and imbalance not only reduce quality of...
BACKGROUND
Dizziness and vertigo rank among the top 10 reasons for emergency and clinical referrals to neurologists. Chronic dizziness and imbalance not only reduce quality of life, but also increase mortality. While the Mediterranean diet has long been considered beneficial for human and planetary health, its effects on chronic dizziness or imbalance are understudied. We investigated the associations of adherence to the Mediterranean diet with chronic dizziness and imbalance.
METHODS
This study used data from the Korea National Health and Nutrition Examination Survey 2019-2021 and included 4,183 adults aged 40 years and older with complete information from diet, dizziness, and neurotology questionnaires. The alternate Mediterranean diet score (aMed) for nine food groups was calculated from 24-hour dietary recall data. Based on questionnaire responses, chronic dizziness was categorized as either isolated or chronic dizziness with imbalance, characterized by a cluster of difficulties maintaining a standing position, walking, or falling.
RESULTS
In a multivariable-adjusted model, the prevalence of chronic imbalance was lower in the top aMed tertile than in the bottom tertile (OR 0.37; 95% CI, 0.18-0.74; p-trend = 0.01). Among the individual aMed components, the intake of whole grains and nuts exhibited an inverse relationship with chronic imbalance (OR 0.50; 95% CI, 0.27-0.93 for whole grains; OR 0.55; 95% CI, 0.31-1.01 for nuts). The aMed score was not associated with isolated chronic dizziness.
CONCLUSIONS
Greater adherence to the Mediterranean diet may reduce chronic imbalance, particularly with an adequate intake of whole grains and nuts.
Topics: Humans; Dizziness; Diet, Mediterranean; Male; Female; Middle Aged; Chronic Disease; Adult; Republic of Korea; Independent Living; Aged; Nutrition Surveys; Postural Balance; Patient Compliance; Surveys and Questionnaires
PubMed: 38822335
DOI: 10.1186/s12967-024-05295-4 -
The use of standing powered wheelchairs from the perspective of individuals with spinal cord injury.Disability and Rehabilitation.... May 2024The aim of this study was to investigate the experiences of standing powered wheelchair (SPWC) users with spinal cord injury (SCI).
PURPOSE
The aim of this study was to investigate the experiences of standing powered wheelchair (SPWC) users with spinal cord injury (SCI).
MATERIALS AND METHODS
This cross-sectional study included 20 participants with SCI. SPWC daily usage time (total, in sitting position and standing position) and the frequency of using the SPWC's standing feature were recorded. Participants' level of satisfaction and comfort associated with the SPWC were assessed on a five-point Likert scale. If there was a dissatisfaction reason with the SPWC, the issues related to it were recorded. Participants were asked about their positive and adverse experiences with the use of SPWC.
RESULTS
Mean age of the participants was 41.65 (± 9.35) years. Eighty percent were tetraplegic. Ninety percent of the participants stood for at least 30 minutes at least one day a week, and 55% stood for at least 30 minutes at least four days a week. The most commonly reported perceived benefits were improvement in activities of daily living, bowel movements, and blood pressure regulation, better perception of body image, and feeling better. The most frequently identified reasons for dissatisfaction with the SPWC were its big dimensions, heavy weight, and difficulty of use in indoor environment and on uneven surfaces.
CONCLUSIONS
The findings show positive perceived experiences for SPWC users with SCI in terms of physical, social, and psychological aspects. Prospective controlled studies are needed to explore the benefits of SPWC use regarding secondary complications of SCI.
PubMed: 38818536
DOI: 10.1080/17483107.2024.2359489 -
Biodiversity Data Journal 2024Centipedes of the family Geophilidae s.l. are widespread in the Holarctic, with the south-eastern part of the European Alps standing out as one of the most investigated...
BACKGROUND
Centipedes of the family Geophilidae s.l. are widespread in the Holarctic, with the south-eastern part of the European Alps standing out as one of the most investigated regions. However, retrieving the published records for this taxon, even for this region, is challenging, since most of them are sparse in the specialised literature and interpreting them is hampered by the many taxonomic and nomenclatorial changes occurred in the past and recent times.
NEW INFORMATION
We assembled and released a dataset of occurrence records of the geophilid species in the south-eastern Alps, including all the published records and many other records present in unpublished catalogues of scientific collections. For each record, we integrated information from all the sources about: locality, date of collection, the taxonomic identifications, number and sex of individuals and available sequences of molecular markers. For all the records, we estimated geographic coordinates of the locality, when not originally provided, based on the information available. We also estimated the accuracy of the position.The dataset includes 3293 records referred to 39 species, obtained since the first half of the 19 century and up to 2022; 52% of these records have been released publicly for the first time in the dataset here described.
PubMed: 38812887
DOI: 10.3897/BDJ.12.e122144 -
Cardio-oncology (London, England) May 2024Cardiotoxicity is a recognized complication in breast cancer (BC) patients undergoing chemotherapy with anthracyclines with or without trastuzumab. However, the...
BACKGROUND
Cardiotoxicity is a recognized complication in breast cancer (BC) patients undergoing chemotherapy with anthracyclines with or without trastuzumab. However, the prognostic value of heart rate variability (HRV) indexes for early cardiotoxicity development remains unknown.
METHODS
Fifty BC patients underwent TTE assessment before and three months after chemotherapy. HRV indexes were obtained from continuous electrocardiograms in supine position with spontaneous breathing, active standing, and supine position with controlled breathing. The magnitude of change (Δ) between supine-standing and supine-controlled breathing was calculated. Variables were compared using t-test or ANOVA. Cardiotoxicity predictive value was assessed by ROC curve analysis. A p value of < 0.05 was considered significant.
RESULTS
TTE revealed reduced left atrial conduit strain in the cardiotoxicity group. Mean heart rate increased during all maneuvers at follow-up, with no differences in HRV indexes between patients with or without cardiotoxicity. However, a lower Δ in supine-controlled breathing of several HRV indexes predicted early cardiotoxicity identified by echocardiography (e.g. SDNN ≤ -8.44 ms: Sensitivity = 75%, Specificity = 69%).
CONCLUSIONS
BC patients treated with chemotherapy maintain cardiac autonomic responses to physiological stimuli after 3 months of chemotherapy. However, a lower Δ during active standing and controlled breathing before chemotherapy may predict early cardiotoxicity.
PubMed: 38812020
DOI: 10.1186/s40959-024-00236-y