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1.
Boris A. Zelle MD Andrea S. Herzka MD Christopher D. Harner MD James J. Irrgang PhD PT ATC 《Operative Techniques in Orthopaedics》2005,15(1):76
Clinical outcomes data can be used to facilitate patient management decisions, assess clinician and organizational performance, and to provide evidence for the effectiveness of surgery and rehabilitation. The validity of the inferences made from outcomes data are dependent on the validity of the outcomes measures themselves and the circumstances under which the data were collected, analyzed, and interpreted. Clinical outcomes may include measures of impairment of body structure and function, activity limitation, and participation restriction. However, because the relationship between impairment and the resulting activity limitation and participation restriction is not direct, and because activity limitations and participation restrictions are of the utmost concern to the athlete, the primary clinical outcome should be measures of activity limitation and participation restriction. Activity limitation and participation restriction may be measured either through direct observation of performance or by general or specific measures of health related quality of life. Clinical outcomes data must be collected systematically to ensure valid inferences from the data. 相似文献
2.
Luzitano Brando Ferreira Celso Teixeira Mendes Cludia Emília Vieira Wiezel Marcelo Rizzatti Luizon Aguinaldo Luiz Simes 《American journal of human biology》2006,18(5):702-705
Allelic frequencies of eight autosomal short‐tandem repeat (STR) loci (TH01, TPOx, CSF1PO, vWA, FES/FPS, F13A1, F13B, and CD4) were determined in 400 individuals born in the State of São Paulo. No significant deviations from Hardy‐Weinberg equilibrium were found in any loci analyzed. The Unweighted Pair‐Group Method with Arithmetic Mean (UPGMA) tree constructed based on genetic distances revealed that the present population was grouped with Europeans, and separated from African and Amerindian populations. Estimates of admixture components based on the gene identity method revealed 79% European, 14% African, and 7% Amerindian contributions to this Brazilian population sample. Am. J. Hum. Biol. 18:702–705, 2006. © 2006 Wiley‐Liss, Inc. 相似文献
3.
Maria ATC van der Loos Ilse Hellinga Mariska C Vlot Daniel T Klink Martin den Heijer Chantal M Wiepjes 《Journal of bone and mineral research》2021,36(5):931-941
Bone geometry can be described in terms of periosteal and endocortical growth and is partly determined by sex steroids. Periosteal and endocortical apposition are thought to be regulated by testosterone and estrogen, respectively. Gender-affirming hormone (GAH) treatment with sex steroids in transgender people might affect bone geometry. However, in adult transgender people, no change in bone geometry during GAH was observed. In this study, we investigated changes in bone geometry among transgender adolescents using a gonadotropin-releasing hormone agonist (GnRHa) and GAH before achieving peak bone mass. Transgender adolescents treated with GnRHa and subsequent GAH before the age of 18 years were eligible for inclusion. Participants were grouped based on their Tanner stage at the start of GnRHa treatment and divided into early, mid, and late puberty groups. Hip structure analysis software calculating subperiosteal width (SPW) and endocortical diameter (ED) was applied to dual-energy X-ray absorptiometry scans performed at the start of GnRHa and GAH treatments, and after ≥2 years of GAH treatment. Mixed-model analyses were performed to study differences over time. Data were visually compared with reference values of the general population. A total of 322 participants were included, of whom 106 were trans women and 216 trans men. In both trans women and trans men, participants resembled the reference curve for SPW and ED of the experienced gender but only when GnRHa was started during early puberty. Those who started during mid and late puberty remained within the reference curve of the gender assigned at birth. A possible explanation might be sought in the phenomenon of programming, which conceptualizes that stimuli during critical windows of development can have major consequences throughout one's life span. Therefore, this study adds insights into sex-specific bone geometry development during puberty of transgender adolescents treated with GnRHa, as well as the general population. © 2021 The Authors. Journal of Bone and Mineral Research published by American Society for Bone and Mineral Research. 相似文献
4.
Does Ultrasound‐Enhanced Instruction of Musculoskeletal Anatomy Improve Physical Examination Skills of First‐Year Medical Students?
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5.
[Purpose] Diabetic peripheral neuropathy can often lead to balance impairment. The spinal
reflex is a mechanism that is reportedly important for balance, but it has not been
investigated in diabetic peripheral neuropathy patients. Moreover, inhibitory or
facilitatory behavior of the spinal reflex—known as presynaptic inhibition—is essential
for controlling postural sway. The purpose of this study was to compare the differences in
as presynaptic inhibition and balance in subjects with and without diabetic peripheral
neuropathy to determine the influence of presynaptic inhibition on balance in diabetic
peripheral neuropathy patients. [Subjects and Methods] Presynaptic inhibition and postural
sway were tested in eight patients (mean age, 58±6 years) and eight normal subjects (mean
age, 59±7 years). The mean percent difference in conditioned reflex amplitude relative to
the unconditioned reflex amplitude was assessed to calculate as presynaptic inhibition.
The single-leg balance index was measured using a computerized balance-measuring device.
[Results] The diabetic peripheral neuropathy group showed lower presynaptic inhibition
(47±30% vs. 75±22%) and decreased balance (0.65±0.24 vs. 0.38±0.06) as compared with the
normal group. No significant correlation was found between as presynaptic inhibition and
balance score (R=0.37). [Conclusion] Although the decreased as presynaptic inhibition
observed in diabetic peripheral neuropathy patients may suggest central nervous system
involvement, further research is necessary to explore the role of presynaptic inhibition
in decreased balance in diabetic peripheral neuropathy patients.Key words: Presynaptic inhibition, Static postural sway, Diabetic peripheral neuropathy 相似文献
6.
Luciano Tavares Angelo Cintra Francine Benetti Aguinaldo Cândido da Silva Facundo Luciana Louzada Ferreira João Eduardo Gomes-Filho Edilson Ervolino Vanessa Rahal André Luiz Fraga Briso 《Journal of endodontics》2013
Introduction
Hydrogen peroxide tooth bleaching is claimed to cause alterations in dental tissue structures. This study investigated the influence of the number of bleaching sessions on pulp tissue in rats.Methods
Male Wistar rats were studied in 5 groups (groups 1S–5S) of 10 each, which differed by the number (1–5) of bleaching sessions. In each session, the animals were anesthetized, and 35% hydrogen peroxide gel was applied to 3 upper right molars. Two days after the experimental period, the animals were killed, and their jaws were processed for light microscope evaluation. Pulp tissue reactions were scored as follows: 1, no or few inflammatory cells and no reaction; 2, <25 cells and a mild reaction; 3, between 25 and 125 cells and a moderate reaction; and 4, 125 or more cells and a severe reaction. Results from each experimental group were compared between groups and within groups to the corresponding unbleached upper left molars and analyzed for significant differences using the Kruskal-Wallis test (P < .05).Results
All tissue sections showed significant bleaching-induced changes in the dental pulp. After 1 bleaching session, necrotic tissue in the pulp horns and underlying inflammatory changes were observed. The extent and intensity of these changes increased with the number of bleaching sessions. After 5 sessions, the changes included necrotic areas in the pulp tissue involving the second third of the radicular pulp and intense inflammation in the apical third.Conclusions
The number of bleaching sessions directly influenced the extent of pulp damage. 相似文献7.
Aguinaldo S. Garcez Eduardo R. Fregnani Helena M. Rodriguez Silvia C. Nunez Caetano P. Sabino Hideo Suzuki Martha S. Ribeiro 《Lasers in medical science》2013,28(1):79-85
This study analyzed the necessity of use of an optical fiber/diffusor when performing antimicrobial photodynamic therapy (PDT) associated with endodontic therapy. Fifty freshly extracted human single-rooted teeth were used. Conventional endodontic treatment was performed using a sequence of ProTaper (Dentsply Maillefer Instruments), the teeth were sterilized, and the canals were contaminated with Enterococcus faecalis 3 days’ biofilm. The samples were divided into five groups: group 1—ten roots irradiated with a laser tip (area of 0.04 cm2), group 2—ten roots irradiated with a smaller laser tip (area of 0.028 cm2), and group 3—ten teeth with the crown, irradiate with the laser tip with 0.04 cm2 of area. The forth group (G4) followed the same methodology as group 3, but the irradiation was performed with smaller tip (area of 0.028 cm2) and G5 ten teeth with crown were irradiated using a 200-mm-diameter fiber/diffusor coupled to diode laser. Microbiological samples were taken after accessing the canal, after endodontic therapy, and after PDT. Groups 1 and 2 showed a reduction of two logs (99%), groups 3 and 4 of one log (85% and 97%, respectively), and group 5 of four logs (99.99%). Results suggest that the use of PDT added to endodontic treatment in roots canals infected with E. faecalis with the optical fiber/diffusor is better than when the laser light is used directed at the access of cavity. 相似文献
8.
Christoper E. Pelt Wes MadsenJill A. Erickson PA-C Jeremy M. GilillandMike B. Anderson MS ATC Christopher L. Peters MD 《The Journal of arthroplasty》2014
We retrospectively reviewed 123 patients who underwent cementless THA with modular femoral stem designs for revision THA or conversion of failed ORIF and found 75 patients available for analysis. The Harris Hip Score (HHS) improved from 52 ± 14 to 86 ± 11 (P < 0.001). The femoral stem was re-revised in eight patients (11%). The mean time to re-revision was 1.1 years (0.13–2.54). Reasons for re-revision included infection (n = 5, 7%), aseptic loosening (n = 2, 3%) and significant pain (n = 1, 1%). There were no failures of the modular junctions. PC stems had an increased rate of intraoperative fractures (PC 28% vs. STS 9%, P = 0.04). Modular cementless femoral stems provide acceptable mid-term results in revision THA. 相似文献
9.
Stephen J. Thomas PhD ATC Katherine E. Reuther BS Jennica J. Tucker BS Joseph J. Sarver PhD Sarah M. Yannascoli MD Adam C. Caro DVM Pramod B. Voleti MD Sarah I. Rooney MSE David L. Glaser MD Louis J. Soslowsky PhD 《Clinical orthopaedics and related research》2014,472(8):2404-2412
Background
Pathology in the long head of the biceps tendon often occurs in patients with rotator cuff tears. Arthroscopic tenotomy is the most common treatment. However, the role of the long head of the biceps at the shoulder and the consequences of surgical detachment on the remaining shoulder structures remain unknown.Questions/purposes
We hypothesized that detachment of the long head of the biceps, in the presence of supraspinatus and infraspinatus tears, would decrease shoulder function and decrease mechanical and histologic properties of both the subscapularis tendon and the glenoid articular cartilage.Methods
We detached the supraspinatus and infraspinatus or the supraspinatus, infraspinatus, and long head of the biceps after 4 weeks of overuse in a rat model. Animals were gradually returned to overuse activity after detachment. At 8 weeks, the subscapularis and glenoid cartilage biomechanical and histologic properties were evaluated and compared.Results
The group with the supraspinatus, infraspinatus, and long head of the biceps detached had greater medial force and decreased change in propulsion, braking, and vertical force. This group also had an increased upper and lower subscapularis modulus but without any differences in glenoid cartilage modulus. Finally, this group had a significantly lower cell density in both the upper and lower subscapularis tendons, although cartilage histology was not different.Conclusions
Detachment of the long head of the biceps tendon in the presence of a posterior-superior cuff tear resulted in improved shoulder function and less joint damage in this animal model.Clinical Relevance
This study provides evidence in an animal model that supports the use of tenotomy for the management of long head of the biceps pathology in the presence of a two-tendon cuff tear. However, long-term clinical trials are required. 相似文献10.