bluuebunny/crossref_metadata_2025 huggingface dataset:
Individualized medicine using 3D printing technology in gynecology: a scoping review
Authors: Cooke Carly M. , Flaxman Teresa E. , Sikora Lindsey , Miguel Olivier , Singh Sukhbir S.
Published: March 2023

Objective

Developments in 3-dimensional (3D) printing technology has made it possible to produce high quality, affordable 3D printed models for use in medicine. As a result, there is a growing assessment of this approach being published in the medical literature. The objective of this study was to outline the clinical applications of individualized 3D printing in gynecology through a scoping review.

Data sources

Four medical databases (Medline, Embase, Cochrane CENTRAL, Scopus) and grey literature were searched for publications meeting eligibility criteria up to 31 May 2021.

Study eligibility criteria

Publications were included if they were published in English, had a gynecologic context, and involved production of patient specific 3D printed product(s).

Study appraisal and synthesis methods

Studies were manually screened and assessed for eligibility by two independent reviewers and data were extracted using pre-established criteria using Covidence software.

Results

Overall, 32 studies (15 abstracts,17 full text articles) were included in the scoping review. Most studies were either case reports (12/32,38%) or case series (15/32,47%). Gynecologic sub-specialties in which the 3D printed models were intended for use included: gynecologic oncology (21/32,66%), benign gynecology (6/32,19%), pediatrics (2/32,6%), urogynecology (2/32,6%) and reproductive endocrinology and infertility (1/32,3%). Twenty studies (63%) printed 5 or less models, 6/32 studies (19%) printed greater than 5 (up to 50 models). Types of 3D models printed included: anatomical models (11/32,34%), medical devices, (2/32,6%) and template/guide/cylindrical applicators for brachytherapy (19/32,59%).

Conclusions

Our scoping review has outlined novel clinical applications for individualized 3D printed models in gynecology. To date, they have mainly been used for production of patient specific 3D printed brachytherapy guides/applicators in patients with gynecologic cancer. However, individualized 3D printing shows great promise for utility in surgical planning, surgical education, and production of patient specific devices, across gynecologic subspecialties. Evidence supporting the clinical value of individualized 3D printing in gynecology is limited by studies with small sample size and non-standardized reporting, which should be the focus of future studies.
Subcutaneous extension of perigraft seroma after thoracic aortic surgery — report of three cases
Authors: Doita Tsutomu , Yamasumi Taro , Nakamura Yuki , Kondoh Haruhiko
Published: March 2023

Background

Subcutaneous extension of a perigraft seroma following thoracic aortic surgery is an infrequently encountered complication. For treatment, it is necessary to first exclude the possibility of perigraft fluid collection secondary to infection, a pseudoaneurysm, or impending rupture. However, it is difficult to diagnose collected fluid as indicative of a perigraft seroma, and there is also no standardized treatment for this condition.

Case presentation

Three patients who had undergone graft replacement of a thoracic aorta with arch reconstruction were referred to our department for findings of a subcutaneous tumor. In each, computed tomography showed perigraft fluid accumulation in the posterior sternum. In one, a subcutaneous tumor had appeared in the center area of the median sternotomy, 4 months after the operation. It was considered that a wound infection was the likely cause; thus, negative pressure wound therapy was started after incisional drainage and debridement. However, a fever developed 14 days after debridement, resulting in mediastinitis, the latter of which was assumed to be caused by a retrograde infection of the incisional wound. In the other two cases, a subcutaneous tumor appeared in the center of the median area of the sternotomy at 3 and 4 months, respectively, after the operation. In both, the tumor was treated with continuous drainage by aspiration with negative pressure, and cultures of drainage samples were negative for infection. Neither patient had a fever during hospitalization, and fluid collection disappeared during follow-up. In one of the latter two cases, a subcutaneous tumor formed again 3 months after drainage, which was treated in the same manner and subsequently disappeared. Thereafter, there was no recurrence noted at the 3-year follow-up examination.

Conclusion

A perigraft seroma following thoracic aortic surgery, an infrequently encountered complication, has an appearance is similar to a subdermal tumor. Continuous aspiration drainage is a useful option for patients with no fever and negative for infection in drainage culture results.
Arterial Stiffness in Transgender Men Receiving Long-term Testosterone Therapy
Authors: Cunha Flávia Siqueira , Bachega Tania Aparecida Sartori Sanchez , Costa Elaine Maria Frade , Brito Vinicius Nahime , Alvares Leonardo Azevedo , Costa-Hong Valéria Aparecida , Verardino Renata Gomes Sanches , Sircili Maria Helena Palma , Mendonça Berenice Bilharinho de , Bortolotto Luiz Aparecido , Domenice Sorahia
Published: March 2023

Context

The effects of androgen therapy on arterial function in transgender men (TM) are not fully understood, particularly concerning long-term androgen treatment.

Objective

To evaluate arterial stiffness in TM receiving long-term gender-affirming hormone therapy by carotid–femoral pulse wave velocity (cf-PWV).

Methods

A cross-sectional case–control study at the Gender Dysphoria Unit of the Division of Endocrinology, HC-FMUSP, Sao Paulo, Brazil. Thirty-three TM receiving intramuscular testosterone esters as regular treatment for an average time of 14 ± 8 years were compared with 111 healthy cisgender men and women controls matched for age and body mass index. Aortic stiffness was evaluated by cf-PWV measurements using Complior device post-testosterone therapy. The main outcome measure was aortic stiffness by cf-PWV as a cardiovascular risk marker in TM and control group.

Results

The cf-PWV after long-term testosterone therapy was significantly higher in TM (7.4 ± 0.9 m/s; range 5.8-8.9 m/s) than in cisgender men (6.6 ± 1.0 m/s; range 3.8-9.0 m/s, P < .01) and cisgender women controls (6.9 ± .9 m/s; range 4.8-9.1 m/s, P = .02). The cf-PWV was significantly and positively correlated with age. Analysis using blood pressure as a covariate showed a significant relationship between TM systolic blood pressure (SBP) and cf-PWV in relation to cisgender women but not to cisgender men. Age, SBP, and diagnosis of hypertension were independently associated with cf-PWV in the TM group.

Conclusion

The TM group on long-term treatment with testosterone had higher aging-related aortic stiffening than the control groups. These findings indicate that aortic stiffness might be accelerated in the TM group receiving gender-affirming hormone treatment, and suggest a potential deleterious effect of testosterone on arterial function. Preventive measures in TM individuals receiving testosterone treatment, who are at higher risk for cardiovascular events, are highly recommended.
Statistical models for quantitative evidence synthesis with an emphasis on network meta-analysis and on meta-analysis of diagnostic tests
Authors: Τσοκάνη Σοφία
Published: March 2023

Τα τελευταία χρόνια, η βιβλιογραφία σε ερευνητικά θέματα σχετικά με την υγεία αυξάνεται ραγδαία. Οι συστηματικές ανασκοπήσεις και η μετα-ανάλυση μελετών παρέμβασης και διαγνωστικής ακρίβειας προσφέρουν την δυνατότητα περίληψης όλης της σχετικής πληροφορίας που είναι διαθέσιμη στην βιβλιογραφία, για κάθε περίπτωση. Ένα βασικό βήμα στη λήψη κλινικών αποφάσεων είναι η διάγνωση: μια σωστή διάγνωση μπορεί να καθοδηγήσει μια σωστή και αποτελεσματική επιλογή θεραπείας/παρέμβασης. Στόχος της παρούσας διατριβής ήταν να συζητηθούν και να απαντηθούν ζητήματα που σχετίζονται με τη σύνθεση στοιχείων από μελέτες παρεμβάσεων και μελέτες διαγνωστικής ακρίβειας (διαγνωστικών τεστ), με έμφαση στις τελευταίες, χρησιμοποιώντας ως εργαλείο την απλή μετα-ανάλυση και την μετα-ανάλυση δικτύου. Τα μέτρα διαγνωστικής ακρίβειας αναφέρονται στην ικανότητα ενός τεστ να διακρίνει μεταξύ της παρουσίας ή της απουσίας μιας συγκεκριμένης κατάστασης (target condition). Για την ποσοτικοποίηση αυτής της ικανότητας διάκρισης των τεστ μπορεί να χρησιμοποιηθεί μία ποικιλία μέτρων διαγνωστικής ακρίβειας. Στο πρώτο μέρος της διατριβής γίνεται εισαγωγή στις συστηματικές ανασκοπήσεις και τις μελέτες διαγνωστικής ακρίβειας. Στη συνέχεια, παρουσιάζονται τα διαθέσιμα μοντέλα για τη διεξαγωγή μιας μετα-ανάλυσης μελετών παρεμβάσεων και διαγνωστικής ακρίβειας, καθώς και οι βασικές υποθέσεις τους. Το δεύτερο μέρος αναφέρεται στη μετα-ανάλυση δικτύου μελετών παρεμβάσεων και στη μελέτη της ποιότητας των δημοσιευμένων μετα-αναλύσεων δικτύου (ως τον Ιούλιο του 2018) στη βιβλιογραφία, χρησιμοποιώντας ως μέτρο την ολοκληρωμένη παρουσίαση μεθόδων και αποτελεσμάτων βάσει των οδηγιών της λίστας PRISMA-NMΑ. Αναφέρονται εκτενώς τα ευρήματα της εμπειρικής αξιολόγησης των αλλαγών στον τρόπο που περιγράφονται οι μέθοδοι αλλά και τα αποτελέσματα των δημοσιευμένων μετα-αναλύσεων δικτύου μέχρι και μετά το 2015, οπότε και δημοσιεύτηκε η λίστα PRISMA-NMA για μετα-ανάλυση δικτύου. Το τελευταίο μέρος της διατριβής περιέχει τα αποτελέσματα της συστηματικής ανασκόπησης που πραγματοποιήθηκε για να εντοπιστούν τόσο μεθοδολογικά άρθρα όσο και εφαρμογές, που αναφέρουν τη χρήση ενός μοντέλου για τη διεξαγωγή μετα-ανάλυσης δικτύου σε δίκτυα τριών τουλάχιστον διαγνωστικών τεστ. Παρουσιάζονται τα χαρακτηριστικά των μεθόδων που εντοπίστηκαν, η περιγραφική ανάλυση των χαρακτηριστικών των δημοσιευμένων εφαρμογών που συλλέχθηκαν, καθώς και η εμπειρική αξιολόγηση των μεθόδων μετά την εφαρμογή τους στα διαθέσιμα δεδομένα. Επιπλέον, περιγράφονται τα P-scores που χρησιμοποιούνται σε δίκτυα παρεμβάσεων για την ιεράρχηση τους με βάση την σχετική τους αποτελεσματικότητα (για μία ή περισσότερες εκβάσεις) και πιο συγκεκριμένα, παρουσιάζεται η επέκτασή τους σε δίκτυα διαγνωστικών τεστ.
Ιnvestigation of potential olfactory and gustatory deterioration on fitness-to-drive of older drivers with and without mild cognitive impairment and comorbidities
Authors: Τούλιου Αικατερίνη
Published: March 2023

Η ανάγκη για αξιόπιστα, τυποποιημένα και επικυρωμένα εργαλεία αξιολόγησης της ικανότητας οδήγησης στους ηλικιωμένους οδηγούς έχει επισημανθεί και συζητηθεί για πάνω από τρεις δεκαετίες. Οι υπάρχουσες νευροψυχολογικές δοκιμασίες για την εκτίμησης της οδηγικής ικανότητας επικεντρώνονται κυρίως στην οπτικο-χωρική προσοχή και την εκτελεστική λειτουργία παρά σε άλλες αισθήσεις. Την τελευταία δεκαετία έχει διαπιστωθεί ότι η οσφρητική επιδείνωση σχετίζεται με τη γνωστική έκπτωση και συχνά προβλέπει τη μετάβαση από την ήπια γνωστική εξασθένηση στην άνοια. Η μεθοδολογία AGILE αναπτύχθηκε και τυποποιήθηκε ως εργαλείο αποτίμησης της ικανότητας οδήγησης των ηλικιωμένων οδηγών. Στο πλαίσιο αυτής της διδακτορικής διατριβής η μεθοδολογία AGILE προσαρμόστηκε ώστε να περιλαμβάνει την οσφρητική δοκιμασία ‘Sniff' and Stick’. Στόχος ήταν να διερευνηθεί η αξία των σχετικών ελλειμμάτων ως προγνωστικών δεικτών της ικανότητας οδήγησης σε τρεις ομάδες οδηγών (ηλικιωμένοι οδηγοί με: (α) χωρίς διαταραχή (ελέγχου), (β) με ήπια νοητική διαταραχή (ΗΝΔ) και (γ) ΗΝΔ και άλλες χρόνιες παθήσεις, δηλαδή συννοσηρότητες). Μέχρι στιγμής, καμία άλλη μελέτη δεν έχει διερευνήσει την προγνωστική αξία των οσφρητικών ελλειμμάτων στην ικανότητα οδήγησης. Τα ευρήματα αποκάλυψαν ότι η διακριτική ικανότητα είναι σημαντική στον πρώτο χρόνο της εξέτασης και καθώς η έκπτωση εξελίσσεται, η ικανότητα αναγνώρισης γίνεται καλύτερος οσφρητικός δείκτης. Ως εκ τούτου, τα αποτελέσματα έδειξαν ότι απαιτούνται λιγότεροι δείκτες σε σύγκριση με την αρχική μεθοδολογία. Οι οσφρητικοί δείκτες ήταν κυρίαρχοι έναντι των νευροψυχολογικών δοκιμασιών, εκτός από την εγρήγορση, για την πρόβλεψη της ικανότητας οδήγησης των ηλικιωμένων οδηγών, ανεξάρτητα από την παρουσία νοητικών διαταραχών και άλλων χρόνιων παθήσεων.
Συνεργατική βηματική κατασκευή ψηφιακών ιστοριών από εκπαιδευόμενους εκπαιδευτικούς γλώσσας
Authors: Νικολοπούλου Μαρία
Published: March 2023

Στο πεδίο της εκπαίδευσης εκπαιδευτικών δεν έχει ερευνηθεί συστηματικά ο τρόπος με τον οποίο θα μπορούσε να υποστηριχθεί η επαγγελματική ανάπτυξη των εκπαιδευτικών που διδάσκουν την ελληνική γλώσσα μέσω της εμπλοκής τους στη δημιουργία ψηφιακών ιστοριών. Η παρούσα διατριβή διερευνά τον σχεδιασμό ψηφιακού εκπαιδευτικού υλικού και εκπαιδευτικών δραστηριοτήτων από εκπαιδευόμενους εκπαιδευτικούς που διδάσκουν την ελληνική γλώσσα ως δεύτερη αλλά και ως πρώτη / πρότυπη μέσω της εμπλοκής τους στη συνεργατική βηματική κατασκευή ψηφιακής ιστορίας. Έχει στόχο να συνεισφέρει στην κατανόηση του τρόπου με τον οποίο ασκούνται και μαθαίνουν οι εκπαιδευτικοί μέσω του σχεδιασμού, στο πώς μπορεί να υποστηριχθεί ο σχεδιασμός τους και πώς η συμμετοχή τους στο σχεδιασμό με διάφορους τρόπους επηρεάζει την ποιότητα των τεχνουργημάτων που δημιουργούνται. Ειδικότερα, η συνεργατική βηματική κατασκευή ψηφιακής ιστορίας στοχεύει: α) στην ανάδειξη της επίδρασης της κατασκευής αυτής στην ανάπτυξη της Τεχνολογικής Παιδαγωγικής Γνώσης Περιεχομένου των εκπαιδευτικών και β) στη μελέτη του ρόλου της βηματικής οικοδόμησης και του αναστοχασμού και της ομότιμης αξιολόγησης που έγιναν ανά στάδιο στην ποιότητα των τεχνουργημάτων που δημιουργούνται και αφορούν τη γλωσσική διδασκαλία. Η διαδικασία διερευνάται μέσω του ερευνητικού εργαλείου της έρευνας σχεδιασμού, ενώ το υλικό που συγκεντρώθηκε κατά τη διάρκεια της έρευνας κατέστη αντικείμενο επεξεργασίας μέσω της ανάλυσης περιεχομένου. Η συναγωγή συμπερασμάτων στο πλαίσιο της διεξαχθείσας ποιοτικής έρευνας πραγματοποιήθηκε μέσω της χρήσης και της αξιοποίησης διαφορετικών ερευνητικών πτυχών (ανάλυση των ψηφιακών ιχνών ηλεκτρονικής δραστηριότητας και αλληλεπίδρασης στο ηλεκτρονικό περιβάλλον wiki και των απαντήσεων των ερωτηματολογίων που δόθηκαν στην αρχή και στο τέλος του εξαμήνου) με στόχο την ενίσχυση και την εμπέδωση της ερευνητικής αξιοπιστίας. Τα αποτελέσματα παρέχουν ενδείξεις ότι η συνεργατική βηματική κατασκευή ψηφιακών αφηγήσεων οδηγεί στη σταδιακή εξοικείωση των εκπαιδευτικών με την Τεχνολογική Παιδαγωγική Γνώση Περιεχομένου (ΤΠΓΠ) και την εξέλιξή τους ως σχεδιαστών εκπαιδευτικού υλικού για το μάθημα της Γλώσσας. Ειδικότερα οδηγεί σε αναθεωρήσεις στη διαμόρφωση των ιστοριών και του σεναρίου, οι οποίες οφείλονται και στον αναστοχασμό της ομάδας ανά προσχέδιο, αλλά και στην ομότιμη αξιολόγηση που έγινε κάτω από τα προσχέδια.
Covid-19 Impact on Greek Tourism Sector and the Implemented Policies
Authors: Briola Konstantina , Briola Helen
Published: March 2023

Tourism is one of the most important economic activities internationally and many countries (e.g. Portugal, Spain, Greece) are highly dependent on the tourism sector. Tourism has always been considered a priority sector in Greece and significant capital investments have been made over the years for its development. The pandemic has driven the global economy into a severe recession and many industries have been significantly affected by the measures taken, including the tourism industry. In response to this crisis, the Greek government, aiming to further develop the tourism sector and restore tourist flows to normal levels, used a series of measures. In this paper, we study the effects of the implemented policies on tourism during the pandemic. Our results indicate that the policies had a direct impact on the increase in tourism flows.
Minilateralism for Multilateralism: What Role for the EU in the Instrumentalization of the Japan-Australia Strategic Partnership
Authors: Charalampaki Effie
Published: March 2023

The era of “permacrisis” gives rise to minilateral arrangements increasingly at the expense of embedded multilateralism in regional governance. The area of the Indo-Pacific has become the bedrock of minilateral security cooperation. The 2022 Joint Declaration on Security Cooperation (JDSC) between Japan and Australia compliments the hub-and-spokes system and poses an opportunity for the European Union to advance its own strategic compass and address regional security and economic issues in transformative and dynamic ways. Minilateralism poses opportunities and challenges. The paper presents policy recommendations for the EU so as to instrumentalize the 2022 JDSC and concludes that despite the merits of informal and non-binding minilateral arrangements, minilateralism should be used to overcome the stalemates in multilateralism rather than replacing inclusive, legally binding, formal agreements that aim at an order-building architecture which advances the role of international institutions.
Ακολουθώντας το Παράδειγμα του Ισραήλ και του Λιβάνου: Επιλύοντας τις Διαφορές επί Θαλασσίων Συνόρων στην Ανατολική Μεσόγειο
Authors: Τσουκαλά Όλγα
Published: March 2023

Η πρόσφατη συμφωνία οριοθέτησης της Α.Ο.Ζ. του Λιβάνου με το Ισραήλ, με τη διαμεσολάβηση των Η.ΠΑ., δημιούργησε μία νέα διπλωματική και ενεργειακή πραγματικότητα στη δυναμικά εξελισσόμενη περιοχή της Ανατολικής Μεσογείου. Το παρόν εγχείρημα πραγματεύεται την νέα συμφωνία, τόσο υπό το πρίσμα των σχέσεων των δύο κρατών, όσο και το διπλωματικό και ενεργειακό γίγνεσθαι, το οποίο δημιουργεί στην περιοχή. Λαμβάνοντας υπ’όψιν την πολιτική πραγματικότητα, η οποία ήθελε μέχρι τώρα το Ισραήλ και το Λίβανο ως κράτη χωρίς καμία διπλωματική σχέση, το παρόν εγχείρημα καταλήγει σε ορισμένες προτάσεις πολιτικής ώστε η συμφωνία να αποτελέσει ευκαιρία αποκλιμάκωσης και πεδίο συνεργασίας για τα εμπλεκόμενα κράτη, ιδίως στην επιδίωξη της ενεργειακής ασφάλειας.
How Heart Rate Variability Biofeedback Can Improve Police Performance: Public Policy Based on Evidence
Authors: Pinc Tânia , Caparroz Luiz H. , Santos Maria Rita C. , Nery Tatiana C. , Santos Marcio Silva
Published: March 2023

We tested the impact of heart rate variability biofeedback (HRV-BF) on police performance in order to reduce protocol gaps and response time in scenarios that simulate life-threatening situations. The sample gathered fifty-one frontline police officers from the city of Barueri in Brazil who were distributed into two groups: (i) the experimental group (26 officers) which attended a 5-days protocol of HRV-BF training; and (ii) the control group (25 officers) which did not train. The performance of both groups was assessed before and after the HRV-BF training, and the results were compared. The findings show that HRV-BF positively impacted the experimental group's performance by decreasing procedural gaps and timing. In contrast, the performance of the control group remained stable. Based on this evidence, the Secretariat of Urban Security and Social Defense of Barueri decided to make HRV-BF into public policy.
Exercise and pregnancy - review of literature and current recommendations
Authors: Kuźniar Aleksandra , Wąsiewicz Edward , Szawica Dominik , Fularska Kamila , Oleszko Michał
Published: March 2023

Introduction: Regular physical activity benefits everyone, regardless of age, considering individual abilities and health conditions. Pregnancy is a special time for women as well as an appropriate time to reassess lifestyle choices and introduce better habits.
Aim of the study: Summary of the current state of knowledge about exercise in pregnancy, recommended forms of physical activity and benefits for health and well-being.
Methods and Materials: A review was conducted in PubMed, ScienceDirect and GoogleScholar including publications from the last 5 years. Literature was searched using the following terms: “physical activity”, “exercise”, “pregnancy”, “resistance exercise”, “aerobic exercise”.
Results: The number of studies focused on benefits of prenatal exercise is escalating. It has been proven that physical activity can prevent gestational diabetes, help in blood glucose, and blood pressure control, improve the mental state of a mother, and contribute to the improvement of placental function. It can also affect a parturition and child postnatal development. At the same time, it turned out that many women do not have the appropriate knowledge and do not undertake the recommended activity during pregnancy.
Conclusion: Interest in the topic of physical activity during pregnancy has increased significantly in recent years, yet further research is needed to dispel the existing doubts and to understand thoroughly the significance of physical activity during pregnancy on maternal and child health. Future educational interventions aimed at pregnant women in terms of safety and recommended forms of activity during pregnancy are necessary to update their knowledge and to help them implement recommendations.
Intranasal Treatment of Acute Rhinosinusitis - Recommendations, Efficacy and Safety
Authors: Sadlik Maria , Abod Leila , Ilnicka Natalia , Matyja Daria , Zuziak Patrycja
Published: March 2023

Introduction and purpose: Acute rhinosinusitis is a common condition worldwide, usually caused by respiratory viruses. Nasal epithelium is their primary point of entry and an active responder to the infection. Therefore, it seems reasonable for the treatment approach to include locally applied drugs. Our purpose is to bring forward up-to-date recommendations of intranasal treatment options for acute rhinosinusitis, and assess their efficacy and safety.

Description of the state of knowledge: Rhinosinusitis is an inflammation of the mucosa present in the nose and the paranasal sinuses. It affects many patients yearly, bearing significant adverse effects on quality of life, productivity and healthcare expenditure. Acute rhinosinusitis lasts less than 12 weeks and is divided into viral, post-viral and acute bacterial rhinosinusitis. It is one of the prevailing reasons for unfounded antibiotics prescription, although it is usually self-limiting. Its treatment depends on the clinical stage of the infection, however, each of them encloses medications administered intranasally. Based on EPOS2020 and scientific publications it seems that nasal decongestants may be prescribed in viral rhinosinusitis, nasal corticosteroids in post-viral rhinosinusitis and nasal saline can prove beneficial in all clinical stages of rhinosinusitis. While used appropriately all aforementioned medications prove to be safe.

Conclusions: In the light of the findings presented in this paper, it can be concluded that acute rhinosinusitis should be treated not only with oral, but also with intranasal drugs. Nasal decongestants are to be considered in viral rhinosinusitis mainly. Nasal corticosteroids show some positive effect in post-viral rhinosinusitis. Nasal saline can be administered in all clinical stages of acute rhinosinusitis. It is crucial to caution the patients against misuse of the medications, in order to prevent their adverse effects.
Corresponsabilidad ciudadana como mecanismo para el fortalecimiento de la convivencia en una localidad de Bogotá
Authors: Palomo Mónica Yulitza , Gallego Betancourth Martha
Published: March 2023

La convivencia ciudadana implica comportamientos de corresponsabilidad. El objetivo del es­tudio fue analizar los elementos relacionados con la corresponsabilidad ciudadana y sus efectos en la convivencia en la localidad de Kennedy. El método investigativo definido fue descriptivo, explicativo, no experimental y transversal. Se recolectó información por medio de entrevistas semiestructuradas y revisión documental para analizar los datos con tasas de participación y diagramas de relaciones. Los resultados mostraron que los comportamientos contrarios a la convivencia surgen por la baja corresponsabilidad entre ciudadanos y autoridades, asociados con el individualismo, el desconocimiento y la desconfianza entre las partes. La corresponsabi­lidad se puede fortalecer si se lograr afianzar la interacción ciudadanía-policía por medio de la divulgación de programas, que involucren a los líderes comunitarios para consolidar la calidad del relacionamiento. Se concluye que lograr corresponsabilidad demanda el compromiso de los habitantes con la convivencia y una función policial efectiva.
Extracorporeal shockwave therapy for diabetic foot ulcers: a feasibility study
Authors: Hitchman Louise H , Totty Joshua P , Cai Paris , Smith George E , Carradice Daniel , Chetter Ian C
Published: March 2023

Objective:

The purpose of this study was to assess the feasibility of delivering extracorporeal shockwave therapy (ESWT) to patients with diabetic foot ulcers (DFUs). It also aimed to explore any potential clinical effect of ESWT on wound healing and investigate whether ESWT offers any patient-reported benefits.

Method:

In this single-centre, mixed methods feasibility study, patients with a DFU who met the eligibility criteria underwent ESWT three times over a seven-day period. Primary outcome was feasibility of delivering the intervention. Secondary outcomes included wound size, number of DFUs healed at 12 weeks and quality of life (QoL). Semi-structured interviews explored participants' experience of undergoing ESWT.

Results:

Of 106 patients screened, 24 (22.6%) were recruited. Following recruitment, two patients were withdrawn from the study with 22 patients included in the final analysis. The mean attendance at clinic was 90.9% and 65.1% for follow-up. The mean score for acceptability and tolerability was 9.86±0.48 (95% confidence interval (CI): 9.62–10.01) and 9.15±2.57 (95% CI: 7.87–10.42), respectively. There were no serious adverse events or side-effects. Of the DFUs, 45.5% healed during follow-up and QoL scores improved until eight weeks. Key themes identified from the qualitative interviews were: desire for fast healing; improved QoL; flexibility of new treatments; and accessibility of transport.

Conclusion:

This study has shown that it is possible to recruit and retain patents into a single-arm study of ESWT for DFUs. This study supports development of a large randomised control trial to determine the clinical and cost-effectiveness of ESWT for DFU healing.
Use of chitosan wound dressing for the treatment of surgical site infection: a case report
Authors: Gupta Alok Kumar , Vyas Abhishek
Published: March 2023

Surgical site infections (SSIs) are treated using topical antiseptics and systemic antibiotics, but some cases are unresponsive to such regimens. This case study reports the effective healing of an SSI by a chitosan wound dressing (MaxioCel; Axio Biosolutions Private Limited, India) in a 63-year-old female patient. The patient presented with an infected, hard-to-heal wound in the abdominal region, developed after a hernia surgery, and was initially treated with standard procedures. However, due to the continuous progression of infection, a highly absorbent, bioactive microfibre dressing was selected for the treatment and was continued for two months with alternate-day dressing changes. After 60 days of treatment, wound healing was observed, along with remission from the infection, as well as reduction in exudate level and pain. The use of chitosan wound dressing in management of hard-to-heal infected wounds provides efficient remission of SSI and a faster healing rate.
Intra-articular Fracture at the Base of the Proximal Phalanx in the Index Finger Following a Punching Mechanism in a Patient with an Ipsilateral Ulnar Claw Deformity: A Case Report
Authors: Lucas Jean-Marc , Haese Jr. Jason P Den , Khatibshahidi Bianca Z , Storm Shawn W
Published: March 2023

Introduction: Altercations involving punching forces constitute 18.5% of all hand injuries. Intra-articular proximal phalanx base fractures of the index finger only account for 0.5% of all hand fractures. There is a paucity of ulnar claw deformities discussed in the literature, likely because ulnar neuropathies rarely remain untreated long enough to progress to deformity. We present the first reported case of a chronic ulnar claw deformity leading to an uncommon finger fracture pattern through an altered punching mechanism. Case Report: A 62-year-old right-hand dominant male who presented to the emergency department for a behavioral health examination was found to have an intra-articular fracture at the base of the proximal phalanx in the left index finger. This occurred secondary to an altered punching mechanism influenced by an existing ulnar claw deformity. Radiographs of the left hand revealed a simple, non-angulated, and minimally displaced oblique fracture at the base of the proximal phalanx. Diffuse edema and ecchymosis of the index finger and gross hypothenar, intrinsic, and adductor pollicis muscle atrophy were observed. A single source of ulnar clawing could not be elicited on the clinical examination alone. Management involving non-operative treatment with buddy-tape and non-weight bearing for 2 weeks was instituted. The patient did not follow-up with orthopedics for repeat evaluation. Conclusion: This case demonstrates a unique fracture that likely occurred due to altered punching biomechanics from an ulnar claw deformity. The authors recommend that clinicians use their best judgment when comparing clinical findings to seemingly benign imaging studies. Early immobilization is crucial to prevent collapse and surgical intervention of intra-articular phalangeal fractures.
A Hidden “Suspender” in Irreducible Isolated Anteromedial Radial Head Dislocations – A Case Report and Review
Authors: Sheth Binoti , Desai Keyur B. , Jain Kamal , Pawar Pankaj
Published: March 2023

Introduction: Isolated anteromedial radial head dislocations are rare and are infrequently associated with hidden musculotendinous sling of superficial brachialis or biceps tendon impeding closed reduction. Failure to identify this impeding tendon can lead an unsuccessful and unstable open reduction surgery. This is the first case of its kind where the delayed presenting patient was treated without resection of the tendon. Case Report: We describe a case of an irreducible neglected isolated anteromedial radial head dislocation in a 7-year-old male child presenting 2 months following injury with features of active heterotrophic ossification (HO). Open surgical exploration 4 months following the injury through the Boyd’s approach revealed a hidden musculotendinous sling of superficial brachialis suspending the radial head anteromedially. Releasing the adhesions and relocation of the tendon allowed spontaneous radiocapitellar joint reduction. The joint congruency was maintained at 18 months and the functional outcome was excellent with a mild flexion-pronation deficit. Conclusion: Awareness of the rare impeding biceps/brachialis tendinous sling in cases of isolated anteromedial radial head dislocation can guide the surgeon to order an indicated preoperative magnetic resonance imaging and plan an early open reduction. HO may occur frequently with such an injury considering the severity of the associated soft-tissue injury.
Osteofibrous Dysplasia of the Clavicle Managed with Intravenous Bisphosphonates: A Case Report and Review of Literature
Authors: Preethiv R , Mohanty Tanmoy , Nanda Saurav Narayan , Samant Saswat , Gulia Ankit , Sandeep Bodanapu
Published: March 2023

Introduction: Osteofibrous dysplasia is a fibro-osseous benign lesion of childhood and infancy that are commonly seen in the anterior shin of the tibia. Osteofibrous dysplasia in the clavicle is rare and in this study, we reported a case of osteofibrous dysplasia arising in the midshaft of the clavicle. Case Report: An 11-year boy presented with complaints of pain and swelling over his left clavicle and was unable to do overhead abduction following a fall while playing 2 years back. Initially, the patient was diagnosed with a left clavicle fracture and was treated conservatively. The pain subsided after 3 months. The patient had re-injury after 6 months, following which pain and swelling of the left clavicle were gradually progressive. On examination, there was a diffuse swelling extending from the medial end to the lateral end of the left clavicle, which was tender, and bony-hard in consistency. The range of movements of the left shoulder was painful and terminally limited. A percutaneous core-needle biopsy was done, suggestive of a benign fibro-osseous lesion. An open biopsy was done from the tumor-normal bone junction, and caseous materials were found inside the medullary canal, the microscopic finding shows fibroblastic proliferation and osteoblastic proliferation laying down the woven bone. We treated the case with intravenous pamidronate injection in 6 months intervals for 2 years. The patient improved symptomatically achieving a full range of movements of the affected shoulder with good radiological consideration of the lesion. Conclusion: Osteofibrous dysplasia is uncommonly seen in the clavicle, and if it is seen, it may mimic osteomyelitis clinically. It should be differentiated from other lesions by radiological, histopathological, and immunohistochemistry findings.
Osteomyelitis of the Pubis Treated by Masquelet Technique in a Football Player: A Case Report
Authors: Kitamura Hitomi , Tomoaki Fukui , Keisuke Oe , Takehiko Matsushita , Ryosuke Kuroda , Takahiro Niikura
Published: March 2023

Introduction: Osteomyelitis pubis is a rare disease that presents with fever, pubic or hip pain, pain during hip movement, and claudication to avoid pain. It most frequently affects young athletes involved in sports that require twisting and cutting, but its exact cause is unknown and no definite treatment has been established. We report a case of pubic osteomyelitis in a young football player who was treated using the Masquelet technique and antibiotics with a good clinical course. Case Reports: A 22-year-old male football player in a national-level university club team visited a nearby clinic complaining of high fever and mild pain in his bilateral hip joints. As a result of examination, we diagnosed osteomyelitis pubis and reconstructed the pubic symphysis by the Masquelet technique. In this case, the joint-like structure of the pubic symphysis was successfully reconstructed, and the patient was able to continue playing the sport. Three years and 3 months after surgery, he had no limitation of bilateral hip joint range of motion and did not display any symptoms while playing football. Conclusion: Masquelet technique could be a novel surgical method for managing osteomyelitis pubis, even in athletes.
Streeter’s Syndrome of Lower Limb Associated with CTEV
Authors: Jaanbasha Mohammed , Nagnur Mohmad Irfan , Mohiuddin Mohammed Siddique , Mohiuddin Mohammed Jalal , Salman Sajid , Sunder C Sham
Published: March 2023

Introduction: The term Streeter’s syndrome is a term used to describe rare ongenital malformations that includes a variety of clinical presentations usually consisting of a constriction band around a part of the body which can be as superficial as involving just the skin which can be only cosmetic and asymptomatic or can be as deep as causing restricted circulation distally which may be in incompatible with life. Such conditions are remarkably rare accounting for an incidence range from 1:1.2 k to 1: 15 k live births and 178:10 k spontaneous abortions [1]. Males and females are uniformly affected. Almost all cases are sporadic; extremely rare evidence of familial transmission. The entity has been described in the literature in 34 different terms, (such as amniotic rupture sequence, ADAM complex, constriction band syndrome, Streeter’s dysplasia, etc.) due to its extremely variable clinical features and lack of understanding of the etiology. This results in a lack of understanding and creates unnecessary stress for the surgeon/physician as well as the parents. Case Report: We discuss case reports of two such cases with their simple nature of treatment with their outcomes. Conclusion: There is a significant deficit in the education of cases with low incidence, such is the case with pediatric patients presenting with amniotic bands, which usually present and are associated with Congenital Talipes Equino Varus deformity. In such cases, improper or incorrect treatment and/or neglect of the constriction may lead to the vascular deficit and eventually auto-amputation of the segment distal to the amniotic band.
Emergently Managed Rare Case of Extraosseous Hemorrhagic Spinal Epidural Cavernous Hemangioma: A Case Report
Authors: Kothari Ajay , Katkade Siddharth , Bhilare Pramod , Sancheti Parag
Published: March 2023

Introduction: Commonly spinal cavernous hemangioma (CH) is found in vertebral body at thoracic level. Purely extraosseous epidural CH contributes only 4% of all CH. In addition, these patients usually present in their 3rd–6th decade of life. Here, we report emergently treated rare case of hemorrhagic extraosseous epidural thoracic CH in a 26-year-old male Case Report: A 26-year-old male presented with inability to walk without support with acute onset paraparesis and hypoesthesia below D7 with positive myelopathy signs. Magnetic resonance imaging showed posterior epidural well-defined homogenous mass from D6-8 region. PET scan ruled out other primary lesions in body. Intraoperative after D6-8 laminectomy extradural vascular mass was found which was bleeding on touch. With adequate hemostasis complete mass was excised and sent for sampling which revealed CH. The patient showed gradual clinical recovery with complete neurological recovery after 3 months with no signs of clinical and radiological recurrence on 2 years of follow-up. Conclusion: Extraosseous epidural CH is very rare presentation; hence, the differentials of schwannoma, lymphoma, tubercular/pyogenic epidural abscess, metastasis, and others must always be ruled out. They can present a decade earlier in a case of hemorrhagic CH with rapid progressive neurological deficit which warrants early surgical decompression like in our case and the foraminal or paravertebral extension needs foraminotomy or thoracotomy for complete excision.
Medial femoral Condyle Stress Fracture: A Case Report
Authors: Ojha Mukund Madhav , Nayak Tushar , Gamanagatti Shivanand , Kumar Vijay
Published: March 2023

Introduction: Stress fractures are common in athletics and military recruits exposed to repetitive mechanical stresses. They are usually located in the weight-bearing lower limb and foot bone, usually in the metatarsals and tibial shaft. The medial femoral condyle is an unusual site for a stress fracture so reporting such a case is imperative. Case Report: We report a case of a medial femoral condyle stress fracture in a young adult without any athletic or military background, which was managed conservatively by cast application. Conclusion: Stress fractures of the medial femoral condyle are an infrequent phenomenon in individuals without any military or athletic background. Surgeons should have to be very vigilant when dealing with cases of indistinct knee pain. Keywords: Stress fracture, medial femoral condyle, insufficiency fracture, sports injury
Delayed Presentation of Non-traumatic Bilateral Leg Pseudoaneurysms Mimicking Soft-Tissue Sarcoma – A Case Report
Authors: Haq Ibrahim Inzarul , Duca Anca , Papaioannou Dimitrios , Dramis Asterios
Published: March 2023

Introduction: Non-traumatic pseudoaneurysms are very rare but should be considered as a differential diagnosis on patients presenting with a thigh mass. Case Presentation: We present an extremely unusual case of a 70-year-old patient who presented with clinical features of a soft-tissue sarcoma of the thigh that instead was proven to be a non-traumatic pseudoaneurysm. There was also incidental finding of bilateral leg non-traumatic pseudoaneurysms. Conclusion: Medical practitioners must consider the possibility of non-traumatic pseudoaneurysm in patients that present with a thigh mass. Keywords: Pseudoaneurysm, non-traumatic, thigh, sarcoma.
Subtrochanteric Fracture after Internal Fixation of Femoral Neck Fracture Using the Hansson Pinloc System: A Case Report
Authors: Yamada Atsuhisa , Yasui Tetsuro , Miki Yuji , Nakamura Shigeru
Published: March 2023

Introduction: Hansson Pinloc system consists of three pins locking into a plate. In biomechanical trials, the novel plate design with its pin configuration enhanced torsional stability. Hansson Pinloc has been used for femoral neck fracture in some countries including Sweden and Japan. Recently, the outcome of a randomized clinical study comparing Hansson Pinloc and conventional Hansson pins was published. However, subtrochanteric fracture after internal fixation using Hansson Pinloc has not been reported in the English literature including the above report. Only several Japanese literatures reported some cases with this post-operative complication. We present a case with subtrochanteric fracture after internal fixation using Hansson Pinloc. Case Report: Subtrochanteric fractures after internal fixation of femoral neck fractures are rare but severe complications. We present our experience of this complication after internal fixation using Hansson Pinloc system which is a new design implant for femoral neck fracture. A 67-year-old woman was diagnosed with a femoral neck fracture of Garden stage I after a fall. She underwent closed reduction and internal fixation using Hansson Pinloc system. At 4 weeks after surgery, she suffered subtrochanteric fracture without any episode of trauma. The patient underwent removal of the instrumentation and internal fixation with a long femoral nail. We get in trouble with removing Hansson Pinloc system due to secondary fracture, and of bone defect. 9 weeks after the second surgery, the patient could get bone union and walk using double T-canes. Conclusion: Surgeons should be cognizant of this post-operative complication before using this system. In osteosynthesis of the femoral neck fracture using Hansson Pinloc, we should keep in mind that subtrochanteric fracture is a possible post-operative complication. Keywords: Femoral neck fracture, Osteosynthesis, Post-operative complication, Subtrochanteric fracture
Subchondroplasty – A Viable Treatment Option for Transient Bone Marrow Edema Syndrome of the Navicular in an Adolescent: A Case Report
Authors: Marriott Tanner , Fakhoury Omar , Mufarreh Naem A , Pedre Maxwell , Cox Zachary , Zats Svetlana
Published: March 2023

Background: Transient bone marrow edema (TBME) is a condition that typically presents in middle-aged adults with a male to female ratio of 3:1. Cases have also been noted in females during the third trimester of pregnancy. Vitamin D deficiency has been linked to this condition as the pathophysiology demonstrates poorly mineralized osteoid in presenting lesions. It is rare for a healthy child or adolescent to present with TBME introducing the purpose of this case study. This case report aims to provide medical and surgical education on TBME in a young and healthy adolescent. To our best knowledge, this is the first report on the use of subchondroplasty to treat transient bone marrow of the navicular in an adolescent male. Case Presentation: A 16-year-old adolescent male with foot and ankle pain is treated from September of 2017 to September of 2019. The patient failed initial conservative treatments. His treatment concluded with subchondroplasty of the navicular bone, typically contraindicated due to the risk of avascular necrosis (AVN). The patient received follow-up in March of 2020, which included additional magnetic resonance imaging (MRI) for long-term treatment outcome data. Conclusion: The patient was successfully treated with subchondroplasty after conservative therapy failed. In patients with TBME, subchondroplasty may not be the best option due to risk of AVN. At 1-year follow-up, our patient was asymptomatic and MRI showed reduction in edema. Keywords: Transient bone marrow edema, bone marrow edema, pediatric bone marrow edema, avascular necrosis, subchondroplasty, case study.
Looking beyond ‘couple’: exploring the relationship between co-conductors facilitating experiential groups for psychodynamic psychotherapy students
Authors: Dudley Jane , Caton Mike
Published: March 2023

The authors, whose trainings include as group analytic psychotherapists, use the theoretical framework of group analysis to facilitate experiential small and median groups for students on trainings in individual psychodynamic psychotherapy. Even though in group analytic practice it would usually be a definite no, the authors found themselves debating whether members who revealed they were a couple in the past could in fact be together in a group. This discussion prompted the authors to reflect closely on their co-facilitator relationship, causing them to consider what they understood by ‘couple’.

It offered up an opportunity (previously unconscious) to explore the binary fixing of conductors as male/female and heterosexual, and whether such fixing may be a defence by the group, including the group conductors, against allowing and exploring a more fluid, nuanced exploration of gender and sexuality. The authors propose that instead of small experiential groups, co-conducted median groups may offer a richer opportunity for such exploration.
Reflective high-sensitivity polarization change imaging using a dual polarizer structure
Authors: Sasagawa Kiyotaka , Okada Ryoma , Haruta Makito , Takehara Hironari , Tashiro Hiroyuki , Ohta Jun
Published: March 2023

In this study, we demonstrate a reflective imaging system in which a dual polarizer structure, consisting of a uniform polarizer and a polarizer on the pixel of a polarization image sensor, enables the detection of weak polarization changes. The uniform polarizer can achieve a high extinction ratio and is used to render the amount of polarization change in a condition that is easily detectable by the polarization image sensor. The polarization image sensor uses two types of polarizers arranged in an orthogonal relationship with each other to obtain complementary signals for polarization rotation. This is also used for differential detection to reduce the in-phase noise components. In the prototype system, the signal characteristics were in close agreement with theoretical considerations. Furthermore, as a demonstration of high-sensitivity polarization rotation imaging, the polarization rotation of a menthol solution in a 150-µm-thick channel was detected.
Investigation of the space-variance effect in digital holography
Authors: yang xingyu , Zhao Zixin , Fan Chen , Du Yijun , Li Junxiang , Zhang Gaopeng
Published: March 2023

In classical Fourier optics, an optical imaging system is regarded as a linear space-invariant system which is only an approximation. Especially in digital holography, the space-variance effect has a great impact on the image quality and cannot be ignored. Therefore, it is comprehensively investigated in this article. Theoretical analyses indicate that, the space-variance effect is caused by linear frequency modulation and ideal low-pass filtering and it can be divided into three states: approximate space-invariance state, high-frequency distortion state, and boundary-diffraction state. Classical Fourier optics analysis of optical imaging systems only considers the first. Regarding the high-frequency distortion state, the closer the image field is to the edge, the more severe is the distortion of high-frequency information. As for the boundary-diffraction state, in addition to the distortion of high-frequency information in the margin, a prominent boundary-diffraction phenomenon is observed. If the space-variance effect of the imaging lens is ignored, we predict that no space-variance effect in image holography will occur when the hologram is recorded at the back focal plane of the imaging lens. Simulation and experimental result were presented to validate our theoretical prediction.