Genu varum and football participation: Does football participation affect lower extremity alignment in adolescents?

BackgroundGenu varum is one of the most common anatomical variations of knee alignment which is considered a risk factor for anterior knee pain and anterior cruciate ligament injury among football players. Considering that millions of children participate in high-level football training, the purpose of this study was to determine the genu varum development in adolescent football players and non-athlete peers. The hypothesis of this study was that genu varum incidence was higher in adolescent football players compared with non-athletic peers.MethodsThe design was a cross-sectional study. Two-hundred and thirty-seven male football players (FG) and aged-matched and anthropometrically similar non-athletes (CG) were recruited into the study. The quadriceps angle and intercondylar–intermalleolar distance were measured to evaluate the leg alignment. The distance between the medial edges of the condyles and malleoli was measured in millimeters using a digital caliper while angle measurements were performed using a photographic technique in a standing position. To analyze the variables, comparison, correlation and regression statistical tests were performed.ResultsThe intercondylar–intermalleolar distance and quadriceps angle values were significantly higher in FG than CG in all ages. In FG, a very strong correlation was found between number of training years and the intercondylar–intermalleolar distance. The prevalence of genu varum was markedly higher in FG than CG (~37% vs. 2%, respectively) based on intercondylar–intermalleolar distance.ConclusionThis study determined that the prevalence of genu varum and abnormal quadriceps angles in adolescent football players is significantly higher compared with their non-athletic peers.     

Dural venous sinus thrombosis after cerebellopontine angle surgery: Should it be treated?

IntroductionDural venous sinus thrombosis is an uncommon, but significant sequela that may occur after resection of a cerebellopontine angle lesion. The natural history and management of this pathology has not been sufficiently studied.MethodsAll operative cases for cerebellopontine angle lesions performed in our local institution dating from 1 January 2005 to 30 June 2018 were retrospectively reviewed to identify patients who developed new post-operative dural venous sinus thrombosis. Patients who developed a significantly narrowed sinus without intrinsic thrombus were also identified. Progression of sinus thrombosis through time was followed, with comparisons made between complications amongst patients with and without a compromised sinus.ResultsOf the 126 patients, 20 were found to have new sinus thrombosis, with another 16 developing a critically narrowed sinus without intrinsic thrombus. These cases are significantly associated with translabyrinthine resection of acoustic schwannoma. 4 patients amongst the thrombosed group were commenced on additional therapeutic anticoagulation or antiplatelets, whilst the rest were observed. Based on available follow up imaging, 10/17 patients had significantly improved sinus thrombosis on serial imaging, including 8/14 amongst those not given additional anticoagulation. Patients with a compromised sinus demonstrated a higher rate of cerebrospinal fluid leak requiring blindsac procedures. When involving a dominant sinus, there is also an association of an increased requirement for permanent CSF diversion.ConclusionTherapeutic anticoagulation should be considered for symptomatic post-operative dural venous sinus thrombosis or if it involves a dominant sinus. Further prospective studies are warranted to better elucidate the risk-benefit justification of treatment for postoperative sinus thrombosis.     

原发性闭角型青光眼合并视网膜色素变性的临床特征分析

目的 分析原发性闭角型青光眼合并视网膜色素变性患者的临床特征。 方法 本研究纳入2013年4月至2017年4月于首都医科大学附属北京同仁医院眼科中心住院治疗的原发性闭角型青光眼(primary angle closure glaucoma ,PACG)合并视网膜色素变性(retinitis pigmentosa,RP)患者32例,和同期入院的不合并RP的PACG患者229例。根据青光眼类型将其分为4组,急性闭角型青光眼合并RP组(acute angle closure glaucoma with retinitis pigmentosa, AACG-RP)12例、慢性闭角型青光眼合并RP组(chronic angle closure glaucoma with retinitis pigmentosa, CACG-RP)20例、急性闭角型青光眼不合并RP组(AACG-non RP)94例、慢性闭角型青光眼不合并RP组(CACG-non RP)135例,比较4组患者的发病年龄和眼轴长度等参数。 结果 患者平均发病年龄AACG-RP组(39.00±12.07)岁、CACG-RP组(43.85±12.79)岁、AACG-non RP组(66.44±9.40)岁、CACG-non RP组(63.95±10.42)岁,4组之间差异有统计学意义(F=47.70,P<0.05)。患者平均眼轴长度AACG-RP组(21.31±1.37)mm、CACG-RP组(22.33±1.09)mm、AACG-non RP组(22.31±1.03)mm、CACG-non RP组(22.47±1.01)mm,4组之间差异有统计学意义(F=19.09,P<0.05)。 结论 原发性闭角型青光眼患者合并视网膜色素变性患者中,急性闭角型青光眼患者较慢性闭角型青光眼患者发病更早,眼轴更短。原发性闭角型青光眼合并视网膜色素变性患者,尤其是急性闭角型青光眼合并视网膜色素变性患者较无视网膜色素变性者发病年龄更早,且眼轴更短。     

Ocular Redness Measured with the Keratograph 5M in Patients Using Anti-Glaucoma Eye Drops

Purpose: To examine correlations between ocular redness measured with the new topographer Keratograph 5M and the use of topical anti-glaucoma medication. Methods: A total of 211 eyes of 211 patients with open-angle glaucoma or ocular hypertension on topical medication and 51 eyes of 51 healthy volunteers were recruited over 10 months. Outcome variables were keratograph redness scores (RS): overall, bulbar temporal (BT), bulbar nasal (BN), limbar temporal (LT), and limbar nasal (LN). In each subject, we also recorded the intraocular pressure-lowering eye drops used, daily doses and daily and cumulative preservative concentrations, fluorescein corneal staining score (OXFORD), lower tear meniscus height (Fourier-domain OCT), non-invasive tear film breakup time (Keratograph 5M), and ocular surface disease questionnaire index (OSDI). Results: Higher RS were recorded in the medication than control group (P < 0.01 all scores). Within the medication group, older patients returned greater RS (P < 0.05 all scores). Prostaglandin was a strong predictor of higher scores, except LN RS. A higher OSDI was associated with a higher LN RS (β = 0.007; P < 0.05), while the use of β-blockers was linked to a lower LN RS (β = ?0.225; P < 0.05). The use of ≥3 daily eye drops with preservative gave rise to a higher BN RS and ≥3 daily eye drops to a higher LN RS (β = 0.366, P < 0.01; β = 0.296, P < 0.05, respectively). Conclusion: Keratograph 5M can objectively detect the hyperaemia induced by glaucoma medication. The factors contributing to ocular redness were advanced age, more daily eye drops (nasal sectors), a higher OSDI, and prostaglandin as the medication used.     

Quality of life after hemifacial spasm surgery: French versions of the HFS-8 and HFS-30 questionnaires

ObjectivesThe aim of the present study was to assess quality of life before and after surgery for hemifacial spasm, in order to validate two specific quality of life scales translated in French. Surgical results and complications were reported.Material and methodsTwenty-three patients with hemifacial spasm treated by microvascular decompression were retrospectively included. The HFS-8 and HFS-30 quality of life scales were translated from English into French using a forward-backward method and implemented on patients at least one year after surgery.ResultsMedian HFS-8 and HFS-30 values were respectively 16 ± 12.5 (range: 8–20.5) and 38 ± 38.5 (range: 23–61.5) before surgery and 0.5 ± 4.5 (range: 0–4.5) and 5 ± 17.5 (range: 1–18.5) after surgery, showing significant improvement in quality of life (P < 0.001). The internal consistency of both scales was excellent (Cronbach's alpha > 0.9), and they were significantly correlated (Pearson coefficient = 0.95; 95% CI [0.91; 0.98]; P < 0.0001). Success rates were 83% and 91%, respectively, after primary and revision surgeries. Complications were transient with minor consequences in 80% of cases, but could impact quality of life when lasting.ConclusionsThese results support the validity of the French versions of HFS-8 and HFS-30. Microvascular decompression is a safe and effective treatment for hemifacial spasm, and these scales are reliable tools to assess postoperative quality of life.