Miracle-dz/UniFAR-FTUs huggingface dataset:
Trends in the United States in the treatment of distal radial fractures in the elderly.

BACKGROUND Traditionally, distal radial fractures in the elderly have been treated nonoperatively with casting. However, since the introduction of the volar locking plating system in 2000, there has been an interest in the use of more aggressive treatment methods. The purpose of the present study was to assess changing trends in the treatment of distal radial fractures in elderly patients in the United States. METHODS We evaluated a 5% sample of Medicare data from 1996 to 1997 and a 20% sample from 1998 to 2005. Information on four treatment methods (closed treatment, percutaneous pin fixation, internal fixation, and external fixation) was extracted from the dataset. Other available data were diagnosis, physician specialty, and patient age, sex, and race. We calculated frequencies and rates to compare the utilization of different treatments over time. RESULTS Over the ten-year time period examined, the rate of internal fixation of distal radial fractures in the elderly increased fivefold, from 3% in 1996 to 16% in 2005. Closed treatment, however, remained the predominant method (used for 82% of the fractures in 1996 and 70% in 2005). Fractures in patients with an age of eighty-five years or more were significantly more likely to be treated in a closed fashion (p < 0.0001). There was a large variation among physician specialties with regard to the fixation methods that were used. Orthopaedic surgeons were significantly more likely to use closed treatment than hand surgeons were, whereas hand surgeons were significantly more likely to use internal fixation than orthopaedic surgeons were. CONCLUSIONS Since 2000, although the majority of distal radial fractures are still treated nonoperatively, there has been an increase in the use of internal fixation and a concurrent decrease in the rate of closed treatment of distal radial fractures in the elderly in the United States.
Prevalence of malformations of the hip joint and their relationship to sex, groin pain, and risk of osteoarthritis: a population-based survey.

BACKGROUND Although the clinical consequences of femoroacetabular impingement have been well described, little is known about the prevalence of the anatomical malformations associated with this condition in the general population, the natural history of the condition, and the risk estimates for the development of osteoarthritis. METHODS The study material was derived from a cross-sectional population-based radiographic and questionnaire database of 4151 individuals from the Copenhagen Osteoarthritis Substudy cohort between 1991 and 1994. The subjects were primarily white, and all were from the county of Østerbro, Copenhagen, Denmark. The inclusion criteria for this study were met by 1332 men and 2288 women. On the basis of radiographic criteria, the hips were categorized as being without malformations or as having an abnormality consisting of a deep acetabular socket, a pistol grip deformity, or a combination of a deep acetabular socket and a pistol grip deformity. Hip osteoarthritis was defined radiographically as a minimum joint-space width of <or=2 mm. RESULTS The male and female prevalences of hip joint malformations in the 3620 study subjects were 4.3% and 3.6%, respectively, for acetabular dysplasia; 15.2% and 19.4% for a deep acetabular socket; 19.6% and 5.2% for a pistol grip deformity; and 2.9% and 0.9% for a combination of a deep acetabular socket and pistol grip deformity. The male and female prevalences of a normal acetabular roof were 80.5% and 77.0%. We found no significantly increased prevalence of groin pain in subjects whose radiographs showed these hip joint malformations (all p > 0.13). A deep acetabular socket was a significant risk factor for the development of osteoarthritis (risk ratio, 2.4), as was a pistol grip deformity (risk ratio, 2.2). Acetabular dysplasia and the subject's sex were not found to be significant risk factors for the development of hip osteoarthritis (p = 0.053 and p = 0.063, respectively). The prevalence of hip osteoarthritis was 9.5% in men and 11.2% in women. The prevalence of concomitant malformations was 71.0% in men with hip osteoarthritis and 36.6% in women with hip osteoarthritis. CONCLUSIONS In our study population, a deep acetabular socket and a pistol grip deformity were common radiographic findings and were associated with an increased risk of hip osteoarthritis. The high prevalence of osteoarthritis in association with malformations of the hip joint suggests that an increased focus on early identification of malformations should be considered.
Mortality in elderly patients after cervical spine fractures.

BACKGROUND Despite an increased risk of cervical spine fractures in older patients, little is known about the mortality associated with these fractures and there is no consensus on the optimal treatment. The purposes of this study were to determine the three-month and one-year mortality associated with cervical spine fractures in patients sixty-five years of age or older and to evaluate potential factors that may influence mortality. METHODS We performed a retrospective review of all cervical spine fractures in patients sixty-five years of age or older from 1991 to 2006 at two institutions. Information regarding age, sex, race, treatment type, neurological involvement, injury mechanism, comorbidity, and mortality were collected. Overall risk of mortality and mortality stratified by the above factors were calculated at three months and one year. Cox proportional-hazard regression was performed to identify independent correlates of mortality. RESULTS Six hundred and forty patients were included in our analysis. The mean age was eighty years (range, sixty-five to 101 years). Two hundred and ninety-four patients (46%) were male, and 116 (18%) were nonwhite. The risk of mortality was 19% at three months and 28% at one year. The effect of treatment on mortality varied with age at three months (p for interaction = 0.03) but not at one year (p for interaction = 0.08), with operative treatment being associated with less mortality for those between the ages of sixty-five and seventy-four years. A higher Charlson comorbidity score, male sex, and neurological involvement were all associated with increased risk of mortality. CONCLUSIONS Operative treatment of cervical spine fractures is associated with a lower mortality rate at three months but not at one year postoperatively for patients between sixty-five and seventy-four years old at the time of fracture.
Determinants of Children’s Self-Esteem: An Examination of Perceived Competence and Affect in Sport

The present study examined perceived sport competence and affect experienced in sport as possible determinants of children’s levels of self-esteem. The sample consisted of 183 summer sport program participants ranging in age from 8 to 13 years. The children completed self-report questionnaires that assessed the constructs of interest. Hypothesized relationships among the constructs were then examined using structural equation modeling techniques. The results revealed that both structural models tested provided an adequate fit with the sample data. For the affect mediator model, perceived competence significantly influenced positive affect and to a lesser degree negative affect, while only positive affect influenced self-esteem. For the perceived competence mediator model, only positive affect significantly influenced perceived competence, which in turn significantly influenced self-esteem. Thus, higher scores on perceived competence and positive affect were associated with higher scores in children’s self.
The international orthopaedic health elective at the University of California at San Francisco: the eight-year experience.

It is estimated that half of the world's population lacks access to adequate primary health care and that two-thirds of the population lacks access to orthopaedic care1. While opportunities for orthopaedic surgeons to volunteer internationally have existed for many years, only a small percentage of practicing orthopaedic surgeons in the United States do so. One reason for this low rate of volunteerism is that physicians who have recently finished residency training face substantial loan burdens. In addition, recent graduates need to establish and build their practices2,3. Residents at the University of California at San Francisco (UCSF) may elect to participate in an overseas volunteerism program as early as their third postgraduate year. This program is rooted in the hope that early exposure will encourage future participation in similar activities throughout the residents' professional lives. While reports on the early experience of this elective have demonstrated a trend toward increased future participation in volunteerism, to date there have been no formal investigations of the long-term impact of this elective experience on orthopaedic surgery residents4,5. International health electives are believed to impact residents-in-training in three ways: providing professional development, affecting health-care resource use, and impacting outlooks and attitudes toward the delivery of health care6. A recent investigation conducted by the Department of Internal Medicine at Yale University examined the effects of its international elective on resident training. The study found that participants in an international elective were more likely than nonparticipants both to switch from subspecialty medicine to general medicine and to care for underserved populations7. While offering an international elective as a standard component of a residency training program may appear to benefit both residents and residency training programs, such electives require a substantial financial commitment from …
Environmental radioactivity of the St. Martin's island of Bangladesh

The activity concentration of natural and anthropogenic radionuclides in soil and rock, and in benthic algae, corals and oysters across the St. Martin's island of Bangladesh were investigated together with physicochemical parameters and texture of soil with an aim of evaluating the radioecology of the island. Soil and rock samples from the twenty-two locations of the island, eleven species of benthic algae, six species of corals and two species of oysters were analyzed. The activity of 226 Ra in soil was found in the range of 7.22–103.8, in benthic algae 2.5–9.7, in coral 5.5–10 and in oyster 4.2–11.5 Bq kg-1 . The activity of 232 Th in soil was found in the range of 14.56–216, in benthic algae 1.3–12.6, in coral 4.4–15.6 and in oyster 3.2–8.4 Bq kg-1 ; and the activity of 40 K in soil was in the range of 322–732, in benthic algae 17.1–45.5, in coral 21–146 and in oyster 24–32 Bq kg-1 . The external radiation dose rate due to activity concentration of natural radionuclides in soil was assessed. The activity of anthropogenic 137 Cs was found below detection limit.
Functional results of isolated femoral revision of hip resurfacing arthroplasty.

BACKGROUND Conversion of a failed femoral resurfacing component is reportedly a straightforward procedure; however, little has been published regarding the functional results following revision. Our primary aim was to compare the functional results for a group of patients who had had isolated femoral component revision after a failed hip resurfacing with those for a group of patients with a surviving hip resurfacing. Our secondary aim was to identify whether the mode of failure affects functional outcome. METHODS Between 1997 and 2002, data were prospectively collected on 5000 Birmingham Hip Resurfacing procedures. One hundred and seventy-seven hips were revised, and, of those, seventy-six had an isolated femoral component revision. We reviewed the modes of failure and the post-revision clinical outcomes for this subgroup (the revised implant group) and compared the results with those for the patients who had a surviving hip resurfacing implant (the surviving implant group). RESULTS The median Harris and Merle d'Aubigné hip scores were significantly better in the surviving implant group than in the revised implant group (median Harris score, 96 compared with 82 [p < 0.001]; median Merle d'Aubigné score, 17 compared with 14 [p < 0.001]). When we analyzed outcomes following revision, we found that the mode of failure affected outcome. Patient satisfaction and clinical outcomes were worse following revision because of femoral component loosening in comparison with revision because of femoral neck fracture or revision because of femoral head collapse or osteonecrosis. In these three subgroups, the median Harris hip scores were 66, 87, and 92, respectively, and the median Merle d'Aubigné scores were 10, 14, and 15, respectively. Six of fifteen patients in the femoral loosening group believed that they were worse or much worse after the revision than they had been before the primary procedure, compared with four of twenty-five patients in the femoral neck fracture group and two of twenty-two patients in the femoral head collapse or osteonecrosis group. Four patients (four hips) experienced complications as a consequence of revision surgery (three deep infections and one case of loosening of an uncemented femoral stem). CONCLUSIONS The functional results for patients who had revision of the femoral component of a current-generation metal-on-metal resurfacing arthroplasty were worse than those for patients with a surviving hip resurfacing. Patients who had revision because of femoral component loosening had worse outcomes than those who had revision because of femoral neck fracture or femoral head collapse or osteonecrosis.
Differences between sexes in lower extremity alignment and muscle activation during soccer kick.

BACKGROUND Injury risk in soccer varies by sex. Female soccer players face a greater risk of anterior cruciate ligament injury and patellofemoral problems, while male players are more likely to experience sports hernia symptoms. The purpose of this study was to test the hypothesis that females have different lower-extremity alignment and muscle activation patterns than males during the soccer kick. METHODS Thirteen male and twelve female college soccer players underwent three-dimensional motion analysis and electromyography of seven muscles (iliacus, gluteus maximus, gluteus medius, vastus lateralis, vastus medialis, hamstrings, and gastrocnemius) in both the kicking and the supporting lower extremity and two additional muscles (hip adductors and tibialis anterior) in the kicking limb only. Five instep and five side-foot kicks were recorded for each player. Muscle activation was recorded as a percentage of maximum voluntary isometric contraction. RESULTS The male soccer players had significantly higher mean muscle activation than their female counterparts with respect to the iliacus in the kicking limb (123% compared with 34% of maximal voluntary isometric contraction; p = 0.0007) and the gluteus medius (124% compared with 55%; p = 0.005) and vastus medialis muscles (139% compared with 69%; p = 0.002) in the supporting limb. The supporting limb reached significantly greater mean hip adduction during the stance phase of the kick in the females compared with that in the males (15 degrees and 10 degrees, respectively; p = 0.006). CONCLUSIONS Differences between the sexes in lower extremity alignment and muscle activation occur during the soccer instep and side-foot kicks. Decreased activation of the hip abductors and greater hip adduction in the supporting limb during the soccer kick in female athletes may be associated with their increased risk for anterior cruciate ligament injury.
The epidemiology, risk of recurrence, and functional outcome after an acute traumatic posterior dislocation of the shoulder.

BACKGROUND Posterior glenohumeral dislocation is less common than anterior dislocation, and less is known about its epidemiology, functional outcome, and complications. The purposes of this study were to determine the epidemiology and demographics of posterior dislocations and to assess the risk of recurrence and the functional outcome after treatment. METHODS We performed a retrospective review of a prospective audit of the cases of 112 patients who sustained 120 posterior glenohumeral dislocations. Patients were treated with relocation, immobilization, and then physical therapy. Functional outcome was assessed with the Western Ontario Shoulder Instability Index (WOSI) and the limb-specific Disabilities of the Arm, Shoulder and Hand score (DASH) during the two years after the dislocation. RESULTS The prevalence of posterior dislocation was 1.1 per 100,000 population per year, with peaks in male patients between twenty and forty-nine years old, and in the elderly patients over seventy years old. Most dislocations (67%) were produced by a traumatic accident, with most of the remainder produced by seizures. Twenty patients (twenty-three shoulders) developed recurrent instability. On survival analysis, 17.7% (95% confidence interval, 10.8% to 24.6%) of the shoulders developed recurrent instability within the first year. On multivariable analysis, an age of less than forty years, dislocation during a seizure, and a large reverse Hill-Sachs lesion (>1.5 cm3) were predictive of recurrent instability. Small persistent functional deficits were detected with the WOSI and DASH at two years. CONCLUSIONS The prevalence of posterior dislocation is low. The most common complication after this injury is recurrent instability, which occurs at an early stage in 17.7% of shoulders within the first year after dislocation. The risk is highest in patients who are less than forty years old, sustain the dislocation during a seizure, and have a large humeral head defect. The risk is lower for most patients who sustain the injury from a traumatic accident, especially if they are older and have a small anterior humeral head defect. There are persistent deficits of shoulder function within the first two years after the injury.
Comparison of intra-articular simple compression and extra-articular distal radial fractures.

BACKGROUND The impact of a single well-reduced or stable intra-articular fracture oriented in the sagittal plane on the outcome of internal fixation of a distal radial fracture is uncertain. We tested the hypothesis that wrist motion and function scores would not differ between patients with an extra-articular fracture and those with a single sagittal intra-articular fracture following open fracture reduction and internal fixation with use of a volar locking plate. METHODS Thirty-seven patients with a single sagittal intra-articular fracture of the distal aspect of the radius and seventy-four age and sex-matched patients with an extra-articular distal radial fracture were retrospectively analyzed with use of data gathered in a cohort study of plate and screw fixation of distal radial fractures. A volar locking plate was used in all patients. The two cohorts were analyzed for differences in motion, grip strength, pain, and Gartland and Werley, DASH (Disabilities of the Arm, Shoulder and Hand), and SF-36 (Short Form-36) scores six, twelve, and twenty-four months after surgery. Differences between the cohorts and differences within each cohort over time were determined with use of regression analysis and the likelihood ratio test. RESULTS Patients with a single sagittal intra-articular fracture and those an extra-articular fracture did not differ significantly with respect to motion, grip strength, Gartland and Werley score, or DASH score at any time point. However, there was a trend toward less pronation (95% compared with 98% of that in the contralateral arm) and less grip strength (76% compared with 81% of that in the contralateral arm) at six months and toward a smaller flexion-extension arc (118° compared with 128°) at one year after surgery in patients with a single sagittal intra-articular fracture. CONCLUSIONS Open reduction and volar locking plate and screw fixation of extra-articular fractures and of simple intra-articular fractures of the distal aspect of the radius are associated with comparable impairment and disability within two years of surgery.
Substance use during and after pregnancy among a national cohort of pregnant women in opioid maintenance treatment and their partners

Background: Most individuals in opioid maintenance treatment (OMT) have had serious polydrug problems in addition to opiate addiction. Prospective studies on substance use among pregnant women in OMT and their male partners on a national level have been scarce and therefore deserve attention. Methods: The European Addiction Severity Index was used to map substance use history among a Norwegian national cohort (2005–2006) of pregnant OMT women (n = 37) and their partners (n = 23), as well as substance use during the last month of pregnancy and 1 year later. Results: Lifetime substance use indicated an average of 8 years of heroin abuse before entering OMT. During the last month of pregnancy one woman and two partners reported using illegal substances, while 1 year later, one women and one partner reported having used illegal substances. The use of legal substances among the partners was significantly reduced from pregnancy to 1 year later (38–20%, p < 0.01), while the use of legal substances among the women increased from 8% to 19%. Conclusion: The results suggest that a majority of OMT mothers in Norway and their partners are able to abstain from most illegal substances 1 year after pregnancy, but the tendency of problem drinking among the women is a concern.
The effect of PRECEDE Model-based educational program on depression level in patients with coronary artery bypass grafting

SM Hazavehei L Sabzmakan A Hassanzadeh K Rabiei تفايرد : 26 / 4 / 86 شريذپ : 6 / 11 / 86 Abstract Background: Depression is among the most important barriers to proper treatment of cardiac patients causing failure in accepting their conditions, decreasing their motivation in following the therapeutic recommendations and thus negatively affects the patients’ function and their quality of life. Objective: To investigate the effect of PRECEDE Model-based educational program on depression level in coronary artery bypass grafting surgery (CABGS) patients. Methods: This was a quasi-experimental study in which 54 post-bypass surgery patients of Isfahan Cardiovascular Research Center were investigated. The patients were randomly divided into two groups marked as intervention and control groups. The data were collected using two questionnaires. Primarily, the Cardiac Depression Scale Inventory questionnaire was used to measure the degree of depression followed by PRCEDE Model-based educational questionnaire to identify the role of educational intervention on patients. The PRECEDE Model-based intervention composed of nine educational sessions per week (60 to 90 min each). The patients were followed up for two months post-intervention. Findings: Following the educational intervention, the mean score of Predisposing factors, Enabling factors, Reinforcing factors, and self-helping behaviors was significantly increased in intervention group compared to control group (p<0.001). Also, a significant difference associated with the mean score of depression level in patients was demonstrated between two groups following the educational intervention (p<0.001) Conclusion: The findings of current study confirmed the practicability and effectiveness of the PRECEDE Model-based educational program on preventing or declining the depression level in CABGS patients.