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1.
Takashi Kitagawa Junsuke Nakase Yasushi Takata Kengo Shimozaki Kazuki Asai Hiroyuki Tsuchiya 《The Knee》2019,26(1):14-19
Background
Patellar tendinopathy is difficult to successfully treat. This study aimed to characterize the pathological changes of the infrapatellar fat pad (IPFP) in patellar tendinopathy (PT), and to investigate the influence of PT on the development of fibrotic changes in the IPFP.Methods
Forty male Wistar rats were randomly divided into PT (n?=?20) and control groups (n?=?20). Bacterial collagenase I (patellar tendinopathy group) or saline (control) was injected, intratendinous, into the patellar tendon. Rats were sacrificed at week 12. The whole knee joint was sagittally sectioned and stained with hematoxylin–eosin and Masson's trichrome. The IPFP samples were graded according to cellularity, fibrosis, and vascularity. The whole IPFP and blue-stained area was measured. Mann–Whitney U tests were used to compare the between-group differences of each score and quantitative value.Results
Scores for cellularity were three (2–3) and 0 (0–1) in the PT and control groups, respectively (P?<?0.01). Mean scores for fibrosis were two (1–3) and 0 (0–1) in the PT and control groups, respectively (P?<?0.01). Mean scores for vascularity were two (2–3) and one (1–1) in the PT and control groups, respectively (P?<?0.01). There was a significant difference in the total score between the PT and control groups (seven (5–8) and two (1–3), respectively) (P?<?0.01). Average percentages of the fibrous area of the IPFP were 38.2?±?26.5% and 11.2?±?3.9% in the patellar tendinopathy and control groups, respectively (P?<?0.01).Conclusion
The IPFP in the patellar tendinopathy group showed greater cellularity, fibrosis, and vascularity than the control group. 相似文献2.
Salman Nazary-Moghadam Mahyar Salavati Ali Esteki Behnam Akhbari Sohrab Keyhani Afsaneh Zeinalzadeh 《The Knee》2019,26(1):88-96
Background
Several investigations have studied gait variability of individuals with anterior cruciate ligament (ACL) deficiency; however, the effect of dual-tasking on the gait variability of these individuals remained unclear. The aim of the present study was to determine the effect of gait speed and dual-tasking on knee flexion–extension variability in subjects with and without ACL deficiency.Methods
The knee flexion–extension Lyapunov exponent (LyE) was measured in 22 ACL-deficient (Mean±SD) (25.95?±?4.69?years) and 22 healthy subjects (24.18?±?3.32?years). They walked at three levels of gait speed in isolation or concurrently with a cognitive task.Results
Repeated-measure analyses of variance (ANOVAs) demonstrated that the interaction of group by gait speed was statistically significant. As the gait speed increased from low to high, the knee flexion–extension LyE significantly decreased for the subjects with ACL deficiency (effect size: 0.57, P?=?0.01). The interaction of group by cognitive load was not statistically significant (P?=?0.07). In addition, the ACL-deficient subjects had statistically slower reaction times than healthy subjects during the dual-task compared with the single-task condition.Conclusions
The ACL-deficient and healthy individuals had a tendency to maintain safe gait. It seems that the ACL-deficient subjects sacrificed the cognitive task more than the healthy individuals to pay more attention toward gait. Additionally, it seems that the gait speed was more challenging than cognitive load on the stride-to-stride variability in the individuals with ACL deficiency. 相似文献3.
Ken Dewitte Marc Claeys Emeline Van Craenenbroeck Koen Monsieurs Hein Heidbuchel Vicky Hoymans Tibor Stoop 《Pathophysiology》2019,26(1):53-59
Aims
We explored the effect of remote ischaemic conditioning (RIC) on endothelial function and on circulating mediators.Methods and results
In 20 healthy male volunteers (mean age 31?±?10 years), flow-mediated dilation (FMD) was measured before and after 20?min of arm ischaemia, followed by reperfusion. Remote ischaemic conditioning (RIC) was performed by applying 3 cycles of 5?min of ischaemia of the leg at the onset of index arm ischaemia. Each volunteer underwent the IR-induced vascular injury protocol with and without RIC in a crossover study design.In the control group, IR significantly reduced FMD (5.9?±?2.9% before IR vs. 2.2?±?3.7% after IR; p?<?0.001). This effect was significantly attenuated by performing RIC (FMD of 5.5?±?3.1% before IR vs. 4.0?±?3.4% % after IR; p for interaction?=?0.01). Serum levels of SOD and ADMA increased significantly whereas MCP-1 and VEGF levels decreased significantly.Only changes in SOD levels were significantly related to the degree of RIC induced protection (r²?=?0.34; p?=?0.018).Conclusion
RIC has protective effects against endothelial IR injury. Our biomarker study suggests that anti-oxidative stress mediators, such as SOD, seem to be more involved in the pathogenesis of RIC-induced protection in humans than angiogenesis factors or chemo-attractant cytokines. 相似文献4.
Shun Wang Jun Jiang Chao Zhang Xuhua Zhang Chuanxin Wang 《Pathology, research and practice》2019,215(4):779-783
Background
LincRNA-p21 is involved in the initiation and progression of many human diseases. We aimed to investigate the expression of LincRNA-p21 in different types of liver diseases.Methods
Serum from patients with primary liver diseases (chronic HBV or HCV infection, hepatitis B virus-related cirrhosis, hepatitis B virus-related HCC, non-HBV/HCV-related HCC, alcoholic liver disease) and HBV negative liver metastatic cancer and control healthy individuals was collected and serum lincRNA-p21 levels were determined by RT-qPCR. Clinicopathological characteristics of the patients were also recorded.Results
Serum lincRNA-p21 levels in patients with chronic HBV infection, hepatitis B cirrhosis, hepatitis B virus-related HCC, chronic hepatitis B virus infection, non-HBV/HCV-related HCC, and alcoholic liver disease were higher than those in the control individuals (P?<?0.001, P?<?0.001, P?<?0.001, P?<?0.001, P?<?0.001 and P?=?0.002, respectively). The serum lincRNA-p21 level was not significantly different between patients with HBV negative liver metastatic cancer and the normal control (P?=?0.80). LincRNA-p21 level was negatively correlated with HBV DNA (P?=?0.02), ALT (P?=?0.01) and AST (P?=?0.01) in patients with liver disease, but not correlated with gender (P?=?0.24), age (P?=?0.11) and AFP level (P?=?0.84). Serum lincRNA-p21 in hepatocellular carcinoma patients was higher than that in liver metastatic cancer patients (P?<?0.001).Conclusion
Serum lincRNA-p21 may serve as a potential biomarker for liver cell damage in patients with hepatitis virus infection, hepatitis B cirrhosis, HBV-related HCC and alcoholic liver disease. 相似文献5.
Nae Yu Kim Jung-Soo Pyo Dong-Wook Kang Seung-Min Yoo 《Pathology, research and practice》2019,215(3):580-585
Objective
The aim of this study was to elucidate the clinicopathological significance and prognostic role of loss of claudin-1 in colorectal cancer (CRC).Methods
The correlations between claudin-1 expression and clinicopathological characteristics, including survival rates, were assessed using immunohistochemistry on 260 archival, paraffin-embedded CRC tissues. In addition, the correlations between cludin-1 and nuclear factor-kappa B (NF-κB), epithelial-mesenchymal transition markers and tumor-infiltrating lymphocytes were investigated.Results
Claudin-1 expression was markedly lost in 42.7% of the 260 CRCs analyzed. Loss of claudin-1 expression significantly correlated with larger tumor size, vascular invasion, higher pT stage, and high metastatic lymph node ratio. In addition, loss of claudin-1 expression significantly correlated with NF-κB activation (P?<?0.001), high SNAI (P?<?0.001), and low E-cadherin (P?<?0.001) expressions. Patients with high immunoscores showed significantly lower rates of claudin-1 expression loss (P?=?0.020). In detail, loss of claudin-1 expression were frequently found in CRCs low CD3- and CD8-positive lymphocytes. There were significant correlations between claudin-1 expression loss and poor overall and recurrence-free survivals (P?<?0.001 and P?<?0.001, respectively).Conclusion
Taken together, our results suggest that the loss of claudin-1 expression significantly correlates with aggressive tumor behaviors, high SNAI expression, lower immunoscore, and poor prognoses. 相似文献6.
Objectives
Pregnancy options counseling, or nondirective counseling of patients with unintended pregnancy, is a “necessary competency” for medical students according the Association of Professors of Gynecology and Obstetrics. Narrative Medicine (NM) utilizes stories of illness to inform clinical practice and promotes self-reflection in medical education. The authors analyzed the effect of a NM workshop on medical students’ ability to provide pregnancy options counseling.Methods
The authors randomized students in the major clinical year at Columbia University Medical Center (CUMC) to either a 2-hour NM workshop or to a control intervention. The NM group participated in reading and reflective writing exercises addressing varying perspectives on pregnancy. Students then completed a video-taped and numerically-scored OSCE (Objective Structured Clinical Examination) regarding pregnancy options counseling. The authors compared mean OSCE scores between the groups.Results
The study analyzed 103 participants. Overall mean OSCE scores were higher in the NM group (11.9?±?1.5, n?=?51) than the control group (11.3?±?1.6, n?=?52) (p?=?0.049).Conclusions
Students undergoing a NM workshop had higher scores on a pregnancy options counseling OSCE.Practice implications
This brief intervention may aid future physicians in providing nondirective pregnancy options. This novel approach to teaching is an easily shared learning tool. 相似文献7.
Background
While surgical reconstruction restores mechanical stability following anterior cruciate ligament (ACL) rupture, many experience early-onset osteoarthritis despite surgery. Neurophysiological changes are hypothesized to contribute to knee osteoarthritis progression. Proprioceptive deficits have been reported following ACL injury/reconstruction; however, vibration perception threshold (VPT) has been less studied. This study explored relationships between pain, VPT, proprioception, function, and strength following ACL-reconstruction.Methods
Twenty individuals (27?±?6 years; 10 males) (standard deviation) status-post ACL-reconstruction were compared with a control group. Measurements included VPT, proprioception (threshold to detect passive movement), pain, function (Knee Outcome Survey (KOS)) and isometric quadriceps strength. Group differences were assessed using Mann-Whitney U tests, side-to-side differences with Wilcoxon Signed Rank tests, and associations evaluated using Spearman correlations.Results
The ACL-reconstruction group had minor functional deficits (15?±?11%) and resting pain (1.8?±?1.7). Impaired VPT and proprioception (hypoesthesia) were demonstrated on surgical compared to contralateral and control limbs (p?≤?0.008). Proprioception was significantly different between contralateral and control knees, but not VPT. Surgical knee proprioceptive deficits and VPT deficits were positively correlated (ρ?=?0.462, p?=?0.047) but not in controls (ρ?=??0.042, p?=?0.862). Strength was negatively correlated to pain (ρ?=??0.589; p?=?0.006), but not to KOS scores, proprioception or VPT (p?≥?0.099).Conclusion
Proprioceptive deficits following ACL injury have been ascribed to loss of afferent input from the torn ligament. Alternatively, multi-modality as well as contralateral sensory deficits suggest a spinal/supraspinal source of neurophysiological findings which may predispose to early osteoarthritis.Level of evidence
III. 相似文献8.
Background
As assessment with inertial-measurement-units (IMUs) increases in research and in clinics, it is important to be aware of the repeatability of these sensors. The objectives of this experiment were to evaluate the measurement repeatability of IMU joint angles using a repeatable robot controller and an anthropomorphic leg phantom and to determine effects of joint speed and sensor positioning on the angles collected by these sensors. Comparisons to an electro-goniometer and three-dimensional (3D) motion capture cameras were also completed.Methods
Two dual-IMU setups (posterior and lateral) were tested concurrently with an electro-goniometer and 3D motion capture cameras using a repeatable robot controller and a leg phantom. All modalities were attached to the phantom, which was flexed 10 times using a pre-programmed motion pathway during each test. Mean angles were compared across tests. Effects of joint speed, sensor re-positioning, and anatomical placement of the sensors on repeatability were assessed.Results
Re-positioning caused greater deviation to the maximum and minimum angles than differences in speed. Overall, the means?±?standard deviations, and 95% confidence intervals of the maximum angles across all tests for the 3D camera markers, electro-goniometer, posterior IMUs, and lateral IMUs were 119.4?±?0.3° (119.4, 119.5), 112.4?±?0.5° (112.3, 112.5), 116.2?±?2.4° (115.7, 116.7), and 118.3?±?1.1° (118.1, 118.6).Conclusions
Both posterior and lateral IMU setups demonstrated acceptable repeatability in measurement of range of motion that was advantageous to manual goniometer methods. Posterior and lateral IMU setups demonstrated overlapping standard deviations about their means. 相似文献9.
Kohei Nishitani Moritoshi Furu Shinichiro Nakamura Shinichi Kuriyama Masahiro Ishikawa Hiromu Ito Shuichi Matsuda 《The Knee》2018,25(6):1254-1261
Background
Although total knee arthroplasty (TKA) using a medial pivot insert reportedly improves kinematics compared with a symmetrical insert, improvements in patient-reported outcomes have not yet been reported. The aim of this study was to determine whether insert designs influenced patient-reported outcomes.Methods
Seventy TKAs for osteoarthritis were randomly allocated to a symmetrical dish insert (SD group: 35 knees) or medial pivot insert (MP group: 35 knees). Thirty-two of the SD group (74.4?±?6.6?years old) and 33 of the MP group (73.8?±?6.0?years old) completed the two-year follow-up. The knee range of motion (ROM) and 2011 Knee Society score (2011KSS) were analyzed pre-operatively and postoperatively.Results
There was no difference in pre-operative ROM or 2011KSS (Symptom: 7.3?±?5.9 in SD group, 8.4?±?5.4 in MP group, P?=?0.432; Satisfaction: 12.6?±?6.9 in SD group, 11.8?±?5.9 in MP group, P?=?0.581; Activity: 35.8?±?18.1 in SD group, 35.2?±?18.6 in MP group, P?=?0.883). At two years, although both group showed good improvement, there were no differences in ROM or 2011KSS (Symptom: 19.3?±?5.0 in SD group, 18.3?±?4.1 in MP group, P?=?0.351; Satisfaction: 24.0?±?7.6 in SD group, 22.9?±?7.9 in MP group, P?=?0.548; Activity: 60.3?±?14.8 in SD group, 54.3?±?17.3 in MP group, P?=?0.137).Conclusions
The medial pivot insert was not superior to the symmetrical insert in patient-reported outcomes at two years after TKA. 相似文献10.
Cody Goessl Paul Estabrooks Wen You Denise Britigan Armando DeAlba Fabio Almeida 《Patient education and counseling》2019,102(5):968-975
Objective
This study evaluates the effectiveness of technology versus in-person, group-initiated diabetes prevention to enhance comprehension of learning objectives between patients with differing health literacy (HL).Methods
Evidence-based content through either a DVD (n?=?217) or in-person, group class (n?=?225) to initiate the intervention. A teach-back call was used to assess comprehension of, and reinforce, learning objectives. Chi-squared was used to determine differences between conditions (DVD vs Class) and HL levels (High n?=?361 vs. Low n?=?81) and regression analyses were used to examine relationships.Results
DVD participants performed significantly better across teach back questions (15.4?±?2.5 v. 14.8?±?2.6, p?<?0.01), demonstrated comprehension in fewer teach-back rounds (1.9?±?0.7 v. 2.1?±?0.7, p?<?0.01), and answered more questions correctly on the first try (4.2?±?1.6 v. 3.4?±?1.8, p?<?0.01). Models for HL levels and modality by HL level were statistically significant (p?<?0.01) favoring the DVD.Conclusion
Initiating a diabetes prevention program with the use of a DVD appears to be a superior option to in-person, class sessions. Teach-back and teach-to-goal strategies enables participants of both high and low health literacy levels to receive and confirm mastery of diabetes prevention objectives.Practice Implications
A teach-back call may improve information uptake increasing the likelihood of health behavior uptake. 相似文献11.
David Latz Erik Schiffner Johannes Schneppendahl Konstantin Klein Lisa Oezel Lars Fabian Seiler Pascal Jungbluth Robert Alexander Kaufmann Joachim Windolf Sebastian Viktor Gehrmann 《The Knee》2019,26(1):33-39
Background
One of the most important activities of daily living is operating a motor vehicle. With increasing age the prevalence of musculoskeletal disorders such as knee osteoarthritis may interfere with an individual's ability to do so safely. Physicians are tasked with determining a patient's ability to drive and yet the necessary joint range of motion required for driving a car has not been characterized.Methods
The range of motion of the right and left knees was recorded using electrogoniometers in 20 healthy subjects while driving a car on three route types (a) city streets, b) country roads and c) highways). Special emphasis was placed on the left knee associated with changing a gear.Results
The range of motion while driving is 40–80° for the right and 20–85° flexion for the left knee. A significant difference was noted for each side (p?<?0.01) with a higher flexion occurring in the left knee (p?<?0.01). The average position of the knee while changing a gear (beginning, maximum, ending) was: right: 55°±10°, 62°±10°, 53°±10°; left: 67°±7°, 39°±8°, 66°±8° (mean flexion±standard deviation).Conclusion
This study characterized the knee range of motion that occurs while driving a car. Our data suggests that common driving activities such as accelerating a vehicle or braking can be achieved with the right knee through a limited range of motion. The greater range of motion and the higher flexion of the left knee are mainly attributed to the gear changing. The present data may benefit physicians in their evaluation of driving capability. 相似文献12.
Martin Juenemann Holger Nef Helge Möllmann Pratibha Singh Christian Troidl Patrick Schramm Manfred Kaps Tibo Gerriets Franz Blaes Marlene Tschernatsch 《Immunobiology》2019,224(2):220-222
Background
An association between Tako-Tsubo cardiomyopathy (TTC) and underlying malignancies has been observed, suggesting that TTC might be the consequence of paraneoplastic phenomena. This study investigates the presence of autoantibodies against cardiomyocytes as well as adrenergic (β1, β2) and muscarinic (M2) receptors in patients with TTC.Methods and results
Serum from 20 TTC patients and 20 controls with ischemic heart disease was obtained. Indirect immunofluorescence testing for intracellular autoantibodies against cardiomyocytes showed a homogenous distribution, as in both groups 9 of 20 sera displayed a characteristic binding pattern of antibodies including vascular walls and intracellular structures. Flow cytometry analysis revealed no difference between TTC and controls in the binding of autoantibodies to the surface antigens of cardiomyocyte HL-1 cells (p?=?0.569, t-test). Flow cytometry analysis of nontransfected wild type cells (p?=?0.633, t-test), M2 receptor-transfected cells (p?=?0.687, t-test), β1 receptor-transfected cells (p?=?0.444, t-test) and β2 receptor-transfected cells (p?=?0.632, t-test) showed similar results for control and TTC sera. Likewise, the binding pattern of TTC patients with a history of neoplasia compared to those without or to controls did not differ significantly (p?>?0.05, u-test).Conclusion
Findings suggest that the presumed paraneoplastic etiology of TTC cannot be attributed to the formation of these antibodies. 相似文献13.
C. Adler Sørensen E. Fuglsang C. Sværke Jørgensen R. Pilmann Laursen A. Larnkjær C. Mølgaard C. Ritz K.F. Michaelsen K. Angeliki Krogfelt H. Frøkiær 《Clinical microbiology and infection》2019,21(4):511.e1-511.e7
Objectives
To examine the effect of a combination of probiotics on the antibody response to pneumococcal and pertussis vaccination in healthy Danish children, aged 8–14 months, at the time of starting day care. Moreover, the cytokine response to lipopolysaccharide of whole blood was assessed.Methods
A total of 290 children were randomly allocated to receive a combination of Bifidobacterium animalis ssp. lactis and Lactobacillus rhamnosus GG daily for a 6-month intervention period, and blood samples were drawn at the start and end of the study. Specific antibody response towards Streptococcus pneumoniae serotypes and Bordetella pertussis toxin, as well as endotoxin-induced interleukin-6 (IL-6) and interferon-γ (IFN-γ) production in blood were analysed by Luminex and ELISA.Results
There was no significant difference between the average individual changes from baseline to end of study in antibody concentrations for S. pneumoniae for both the probiotics (340.4% ± 11.2%) and the placebo group (382.9% ± 10.4%) (p 0.525), nor for B. pertussis toxin in the two groups (probiotics 190.1% ± 12.6% versus placebo 238.8% ± 1.1%, p 0.340). The average individual change in IL-6 concentration was significantly lower in the probiotics versus the placebo group (2.9% ± 10.3% versus 33.7% ± 9.0%, p 0.024), whereas there was no difference in IFN-γ concentration (0.0% ± 0.2% versus –0.2% ± 0.1%, p 0.279).Conclusions
The probiotic intervention did not affect the antibody response against S. pneumoniae and B. pertussis toxin in healthy Danish children. 相似文献14.
Objectives
To investigate the effects of various diets on structure and function of the bladder in both normal and obstructed bladders of male Wistar rats.Methods
Sham-operated rats and rats with experimentally-induced bladder outlet obstruction (BOO) were fed with standard rats’ feed (control), High-carbohydrate (HCD), High-fat (HFD) and High-protein (HPD) diets. Feeding was continued for 4 weeks after BOO surgery. Bladder weight, detrusor contractility, Rho-Kinase (ROK) and Myosin Light Chain Kinase (MLCK) expressions were determined using standard methods.Results
In comparison with control, bladder weight was increased in HFD (164?±?9?mg), BOO (437?±?21?mg), HFD-BOO (523?±?19?mg) and HPD-BOO (268?±?18?mg). Detrusor contractility was reduced in BOO and HFD-BOO. The ROK- I and II expressions were high in HCD-BOO and low in HPD-BOO but ROK-I was also elevated in BOO. However, MLCK increased only in HCD-BOO.Conclusion
The results of the study reveal that diets with varying macronutrient compositions have variable effects on the bladder with and without obstruction. High-fat diets especially, affect detrusor morphology and function in both obstructed and unobstructed bladders. 相似文献15.
16.
DN Aguiar MM Silva WV Parreira FD Tome LF Batista CM Gomes MA Oliveira 《Chinese medicine》2012,7(1):17-9
Background
Electroacupuncture (EA) has been used to treat inflammatory diseases. Alternatively activated macrophages (AAMo) stimulated by cytokines such as interleukin (IL)-4, IL-10 and IL-13 are anti-inflammatory and mildly microbicidal. This study aimed to evaluate whether EA at the Zusanli acupoint (ST36) would change the profile of healthy murine macrophages, particularly the generation of AAMo and susceptibility to Leishmania major infection.Methods
BALB/c mice were treated with EA (15/30?Hz) at the ST36 acupoint for 20?min/d for 5 d. After the final EA session, the mice were euthanized and their peritoneal cells were harvested and counted for determination of arginase activity, nitric oxide (NO) production and microbicidal activity after culture in the presence or absence of IL-4, interferon-?? (IFN??) or lipopolysaccharide (LPS) or both IFN?? and LPS. Twelve mice were infected with L. major promastigotes into the footpads after the final EA session and the infection course was monitored.Results
Peritoneal cells freshly obtained from EA-treated mice had similar arginase and microbicidal activities to cells from sham-treated mice. After culture with IL-4, cells from EA-treated mice exhibited significant increases in the arginase activity (sham: 58?±?11.3 vs. EA: 80.7?±?4.6%, P?=?0.025) and number of parasites/infected cell (sham: 2.5?±?0.4 vs. EA: 4.3?±?0.8 cells, P?=?0.007). The NO production was lower in cells from EA-treated mice cultured in the presence of a combination of IFN?? and LPS (sham: 31.6?±?6.5 vs. EA: 22.3?±?2.1???M, P?=?0.025). The lesion size in mice infected with L. major promastigotes was larger in EA-treated mice (sham: 3.26?±?0.29 vs. EA: 2.23?±?0.4?mm, P?=?0.039).Conclusion
EA at the ST36 acupoint increases IL-4 responsiveness in macrophages, Generation of AAMo and susceptibility to L. major infection 相似文献17.
Karen A. Lindsley 《Patient education and counseling》2019,102(5):944-951
Objective
To develop a patient-centered informed consent and assessment tool written at a 6th grade-level that is multimodal, affordable, transportable, and readily modifiable for protocol updates.Methods
This quality improvement initiative was performed in two phases on an actively-recruiting study at a pediatric diabetes clinic. In phase I, 38 volunteers underwent the standard-paper consent process, a comprehension assessment and provided feedback. Using feedback and the structure of the Plan-Do-Study-Act cycle a multimodal consent and assessment were developed. In phase II, volunteers were randomized to the standard (n?=?25) or the multimodal consent (n?=?25) and all completed the same comprehension assessment via touch-screen tablet. Primary outcomes were comparison of the individual and total comprehension assessment scores.Results
Total comprehension scores were higher in the multimodal versus the standard consent group (p?<? 0.001) and on the elements of benefits (p?<? 0.001), risks (p?<? 0.001), volunteerism (p?<? 0.012), results (p?<? 0.001), confidentiality (p?<? 0.004) and privacy (p < 0.001).Conclusion
A multimodal consent and assessment presented sequentially on a touch-screen tablet were patient-centered enhancements to standard consent.Practice implications
Multimodal standardization of delivery with improved readability may strengthen the informed consent process. 相似文献18.
Background
There are limited reports about management of Knee flexion contracture (KFC) in haemophiliacs with Ilizarov technique. The aim of this study was to retrospectively analyzed the results of Ilizarov technique to treat KFC.Methods
Six patients with haemophilia A and one with haemophilia B were included in this study, with an average age of 17?years old. The mean preoperative KFC and flexion angle of the knee were 58?±?21° (mean ± standard deviation) and 127?±?12°, respectively. Preoperative HSS score (hospital for special surgery knee score) was 51?±?4. The average time of follow-up was 39.3?±?23.3?months.Results
All the patients achieved full correction of flexion contracture at the end of distraction and maintained at the last follow-up. The mean flexion angle at the end of distraction and at the last follow-up were 41?±?35° and 38?±?19° respectively, which were significantly lower than preoperative flexion angle. The mean HSS score at the end of distraction and at the last follow-up were 65?±?4 and 64?±?2 respectively, which were significantly higher than the preoperative HSS score. One patient suffered from transient numbness of left leg, and all the patients had loss of range of knee flexion at last follow-up.Conclusions
Ilizarov is an effective and safe procedure to treat KFC in haemophiliacs. However, loss of knee flexion was the most common complication. 相似文献19.
Matthias Steinwachs Nicola Cavalcanti Santhosh Mauuva Venkatesh Reddy Clement Werner Daniel Tschopp Hema N. Choudur 《The Knee》2019,26(1):174-184
Background
CARGEL (Smith & Nephew Inc.), a chitosan-based polymer scaffolding biomaterial, has been used since 2012 for treating articular cartilage lesions. Limited data are available on patient outcomes following CARGEL treatment. This study aimed to describe short-term clinical and radiographic outcomes in a cohort of patients treated with CARGEL and microfracture surgery for articular cartilage defects in the knee.Methods
A retrospective cohort study was conducted of consecutive patients with articular cartilage defects who had undergone microfracture surgery with CARGEL, or in patellar lesions microfracture and CARGEL plus Chondro-Gide (at SportsClinic Zurich). Study outcomes included reoperations, infections, allergic reactions, pain, swelling, range of motion, and tissue quality and quantity. Ethics approval was obtained from the local ethics committee on 05/09/2017 (Basec. Nr: 2017-01441).Results
A total of 91 participants, with 93 treated lesions, consenting to chart review were included. No participants required reoperation due to complications on the index lesion. Fifteen participants had second-look surgery on the index knee for other reasons, allowing for visual confirmation of cartilage repair. No study participants experienced a post-surgical infection or suffered an allergic reaction. No significant changes in range of motion or T2 values were observed from pre-treatment to post-treatment follow-up. However, significant decreases were found in pain (P?<?0.001) and swelling (P?<?0.001), along with significant increases in MOCART II scores (P?<?0.001). Similar results were found in a subgroup of patients with patellar lesions.Conclusions
Patients treated with CARGEL experienced few postoperative complications and reported promising reductions in pain and swelling after treatment.Level of evidence
IV 相似文献20.
Binnari Kim Yun-jeong Jang Sujin Park Jung-Il Lee Hong Kwan Kim Joungho Han 《Pathology, research and practice》2019,215(4):807-815