bluuebunny/crossref_metadata_2025 huggingface dataset:
Bowel cancer screening
Authors: Scott John A
Published: June 2019

Uptake of bowel cancer screening (BCS) is a complex multifactorial problem. This article seeks to outline the current BCS screening modalities. It examines the drivers and barriers to BCS uptake. Finally, it aims to provide practical evidence-based guidance on how best to increase BCS uptake in practice.
A New Flavone Glycoside From Lumnitzera littorea with In Vitro α-Glucosidase Inhibitory Activity
Authors: Thuy Nguyen T. L. , Thuy Pham T. , Tung Bui T. , Loc Huynh T. , Dang Truong T. T. , Ngoc Le L. , Duc Nguyen X. , Dung Le T. , Hansen Poul E. , Phung Nguyen K. P.
Published: June 2019

A new flavone glycoside, lumnitzerone (1), was isolated from leaves of Lumnitzera littorea, together with 9 known flavonoids. Their structures were elucidated by spectroscopic (one-dimensional, two-dimensional nuclear magnetic resonance) and high-resolution mass spectrometry analysis, and comparison with literature data. Extracts and all isolated compounds were evaluated for α-glucosidase inhibitory activity; all the extracts and most of the isolated compounds exhibited better activities than the positive control acarbose.
Phytochemical and Micromorphological Characterization of Croatian Populations of Erodium cicutarium
Authors: Ljoljić Bilić Vanja , Stabentheiner Edith , Kremer Dario , Dunkić Valerija , Grubešić Renata Jurišić , Rodríguez Jadranka Vuković
Published: June 2019

The aim of this study included the phytochemical screening of extracts and essential oil of Erodium cicutarium (L.) L’Hér. ex Aiton (Geraniaceae), a native traditional medicinal plant from Croatia, as well as a highly detailed micromorphological characterization of its aerial parts. The contents of total polyphenols and tannins (TP and T), total flavonoids (TF), and total hydroxycinnamic derivatives (THD) in plant extracts were quantified in plant material from 4 localities (Plitvice, Podvinje, Buzin, and Trešnjevka). The contents of TP, T, TF, and THD significantly varied depending on the collection site, and were in the range of 4.78%-12.85% (TP), 3.23%-5.80% (T), 0.42%-1.09% (TF), and 1.08%-2.59% (THD) of dry weight of plant material, with the Plitvice collection having the highest polyphenol content. GC-MS analysis of the essential oils showed a similarity in composition of the major compounds from all investigated populations. Fifty compounds were identified in all 4 investigated oils (90.4%-96.7% of total oil) and classified into 7 structural classes, with hydrocarbons (59.8%-65.7%) as the main class of constituents. Two types of trichomes, nonglandular and glandular, were observed on the calyces, leaves, and stems, including 3 capitate trichome types. The bioactive substances and micromorphological characterization of Croatian populations of E. cicutarium were investigated for the first time. In general, the scanning electron microscopy imaging of Erodium cicitarium trichomes has not been reported before.
Evaluation In Vivo and In Vitro of the Antioxidant, Antinociceptive, and Anti-Inflammatory Activities of Biflavonoids From Ouratea hexasperma and O. ferruginea
Authors: Oliveira Poliana de Araujo , Fidelis Queli Cristina , Fernandes Thayane Ferreira da Costa , Souza Milene Conceição de , Coutinho Dayane Magalhães , Prudêncio Edlene Ribeiro , Castro Rosane Nora , Riger Cristiano Jorge , Carvalho Mario Geraldo de , Marinho Bruno Guimarães
Published: June 2019

Ouratea species are used for the treatment of inflammation-related diseases such as rheumatism and arthritic disorders. The Ouratea genus is a rich source of flavonoids and bioflavonoids and for this reason we evaluated the effects of the biflavonoid fractions from the leaves of O. hexasperma (OHME) and O. ferruginea (OFME) in the in vivo model of complete Freund’s adjuvant (CFA)-induced arthritis and in the in vitro model of oxidative stress and cellular viability. The CFA-induced arthritis model in rats was followed by paw volume, articular incapacitation and Randall-selitto models, as well as quantification of cytokines and serum C-terminal telopeptide of type I collagen levels. OHME and OFME demonstrated antinociceptive and anti-inflammatory activities, as well as improvement in articular incapacity and reduction in levels of interleukin 1β (IL-1β), IL-6, tumor necrosis factor α, and type 1 collagen, and increased cell viability. No adverse effects were observed. The results suggest that OHME and OFME can reduce inflammation and bone resorption besides their antioxidant action.
Assessment of Potential Anticancer Activity of Brown Seaweed Compounds Using Zebrafish Phenotypic Assay
Authors: Rusdi Nur ‘Afina , Kue Chin Siang , Yu Ke-Xin , Lau Beng Fye , Chung Lip Yong , Kiew Lik Voon
Published: June 2019

Despite the extensive work on anticancer drug discovery, the number of potent lead compounds that enter the preclinical and clinical trials thus far is still low due to the poor selectivity and understanding in pharmacodynamics. In view of the homology between zebrafish embryogenesis and carcinogenesis in human, zebrafish embryos can be used in the screening platform to elucidate the molecular targets of potential anticancer compounds. In the present study, the possible targets modulating the potential anticancer effects of selected brown seaweed-derived compounds (ie alginate, fucoidan, phloroglucinol, fucosterol, and fucoxanthin) were examined. Teratogenic effects induced by the compounds were observed after 72 hours post-fertilization. Fucoidan, phloroglucinol, and fucosterol were observed to significantly reduce the pigmentation of the zebrafish in a dose-dependent manner at low concentrations (fucoidan, <60 µg/mL; phloroglucinol, <10 µg/mL; fucosterol, <3 µg/mL). On the other hand, embryos treated with fucoxanthin at 200 µg/mL and 300 µg/mL exhibited either phenotypes of curved trunk or bent tail. Further validation work using dual antiplatelet therapy (DAPT) and dorsomorphin as positive controls suggest that fucoxanthin might target the Notch and bone morphogenetic protein (BMP) pathways, respectively. Findings from this exploratory study henceforth have demonstrated the utility of zebrafish embryo to accelerate the discovery of potential compounds for targeted anticancer therapy.
Phomanones A-C From Phoma sp. HDN16-618: A Mariana Trench Fungus
Authors: Lu Changjun , Li Changlong , Gan Qi , Zhao Yi , Liu Congcong , Gu Qianqun , Zhu Tianjiao , Zhang Guojian , Che Qian , Li Dehai
Published: June 2019

Three new compounds, phomanones A-C (1-3), and a known compound, 2-hydroxymethyl-3-methylcyclopent-2-enone (4), were isolated from Phoma sp. HDN16-618, a fungus derived from a sea water sample collected from Mariana Trench. Their structures, including absolute configurations, were elucidated by extensive Nuclear Magnetic Resonance (NMR), Mass Spectrometry (MS), and electronic circular dichroism analyses. None of the compounds showed significant cytotoxic activity against a panel of cancer cell lines.
Volatile Components of Heartwood, Sapwood, and Resin From a Dated Cedrus brevifolia
Authors: Douros Andreas , Christopoulou Anastasia , Kikionis Stefanos , Nikolaou Konstantinos , Skaltsa Helen
Published: June 2019

In the present study, the heartwood and the sapwood of a thick wood disc from a dated Cedrus brevifolia trunk, and the resin were analyzed for their volatile components. All samples were subjected to headspace solid-phase microextraction followed by gas chromatography mass spectrometry analysis. The main constituents were β-himachalene (22.2 %) in heartwood and (25.0 %) in sapwood, and α-pinene (37.8 %) in resin.
Among Commercially Available Fruit Juices, Pomegranate Is the Most Effective Inhibitor of PMS-Trypsin Amyloid-Like Fibrils Formation
Authors: Kasi Phanindra Babu , Kotormán Márta
Published: June 2019

The formation of amyloid fibrils is associated with many human illnesses, such as Alzheimer’s, Huntington’s, and Parkinson’s diseases, amyotrophic lateral sclerosis, spongiform encephalitis, type 2 diabetes, and primary and secondary systemic amyloidosis. Nutrition contributes to the prevention of these diseases. The aim of our work was to look for commercially available fruit juices that can inhibit the formation of amyloid fibrils. Of the fruit juices that we examined, that of pomegranate was found to be the most effective inhibitory agent using turbidity measurements and Congo red binding assay. According to our experiments, pomegranate juice reduced the amount of PMS-trypsin amyloid-like fibrils to 3.7% at 5-fold dilution compared with the sample without pomegranate. The inhibitory effect of the pomegranate juice was concentration dependent.
Skin Lightening Effect of the Dietary Intake of Citrus Peel Extract Against UV-Induced Pigmentation
Authors: Kim Jeong-Kee , Park Nok-Hyun , Hwang Jae-Sung
Published: June 2019

Recent studies revealed that citrus peel has beneficial effects in various disorders associated with nitric oxide and/or oxidative stress. In this study, we investigated the effects of Jeju citrus ( Citrus unshiu) peel using various in vitro and in vivo methods. First, the inhibitory effect of citrus peel extract (CPE) on enzymatic activity of tyrosinase was evaluated. Tyrosinase activity was dose-dependently decreased by CPE. Second, the effect of CPE on melanogenesis was determined by measuring the melanin content in melan-a cells. The inhibitory effect of CPE on melanin synthesis was greater than that of vitamin C. Finally, the effect of long-term supplementation with CPE on ultraviolet B-induced skin pigmentation was examined in guinea pigs. Administration of CPE improved Δ L-value compared with the nontreated ultraviolet control group. As a strong inhibitor of melanogenesis, CPE could be used as a depigmentation agent and a supplement for skin lightening.
The ratio of fasting plasma glucose to hemoglobin A1c as a predictor of all-cause mortality in individuals with normal glucose levels: The Jichi Medical School cohort study
Authors: Kakehi Eiichi , Kotani Kazuhiko , Gotoh Tadao , Kayaba Kazunori , Ishikawa Shizukiyo
Published: June 2019

Objectives:

The fasting plasma glucose/hemoglobin A1c ratio is considered a marker associated with glucose metabolism disorders, including fasting hyperglycemia. However, it remains unclear whether this ratio can be used for the prevention of deaths in individuals with normal fasting plasma glucose levels. This study aimed to see the predictive value of the fasting plasma glucose/hemoglobin A1c ratio for all-cause mortality in a general population with normal fasting plasma glucose levels.

Methods:

The study investigated prospectively a cohort of 1087 multi-regional, community-dwelling Japanese participants (women, 69.2%) for a follow-up period of 11.3 years. We included individuals with fasting plasma glucose levels <6.11 mmol/L and excluded those meeting the diabetes criteria. All-cause mortality was the primary outcome and hazard ratios were calculated using the Cox proportional hazard model after dividing the fasting plasma glucose/hemoglobin A1c ratios into tertiles.

Results:

There were 54 deaths (25 women) during the follow-up period. The high tertile group had a significantly higher hazard ratio for all-cause mortality than the low tertile group in women (multivariate-adjusted hazard ratio = 4.45; 95% confidence interval = 1.26–15.72), but not clearly in men.

Conclusion:

The data of the population-based cohort study suggest that a high fasting plasma glucose/hemoglobin A1c ratio can predict all-cause mortality in women with normal fasting plasma glucose levels.
LncRNA MALAT1 contributes to non-small cell lung cancer progression via modulating miR-200a-3p/programmed death-ligand 1 axis
Authors: Wei Shuquan , Wang Kangwei , Huang Xiaomei , Zhao Zhuxiang , Zhao Ziwen
Published: June 2019

This study was to investigate the expression correlation between long non-coding RNA metastasis-associated lung adenocarcinoma transcript 1 (lncRNA MALAT1), miR-200a-3p and programmed death-ligand 1 (PD-L1) in non-small cell lung cancer (NSCLC), and their roles in NSCLC. Real-time polymerase chain reaction (PCR) was performed to detect the expressions of MALAT1, miR-200a-3p and PD-L1 in NSCLC tissues and cells for the correlation analysis. The starBase and Targetscan databases were used to predict the binding sites between MALAT1 and miR-200a-3p, and miR-200a-3p and PD-L1, respectively. The targeting relationship between MALAT1 and miR-200a-3p, and miR-200a-3p and PD-L1 were further verified by real-time PCR and dual luciferase reporter gene assay. Cell proliferation was monitored by CCK8 and colony formation assays. The apoptosis was detected using flow cytometry. Wound healing assay and transwell assay were conducted to determine cell migration and invasion. In this study, we demonstrated that in NSCLC tissues, the expression level of MALAT1 was negatively correlated with that of miR-200a-3p, while positively correlated with PD-L1. Besides, MALAT1 promoted proliferation, mobility, migration, and invasion of NSCLC cells via sponging miR-200a-3p. PD-L1 was validated as a target of miR-200a-3p, and indirectly modulated by MALAT1. In conclusion, LncRNA MALAT1 facilitates the progression of NSCLC by modulating miR-200a-3p/PDL1 axis.
NLRP2 is highly expressed and promotes apoptosis in a mouse model of kidney ischemia/reperfusion injury
Authors: Yu Xueyuan , Zhang Xiumei , Hu Zhao
Published: June 2019

The aim of this study was to investigate the role of nucleotide-binding oligomerization domain, leucine-rich repeat, and pyrin domain containing 2 (NLRP2) in kidney ischemia/reperfusion injury. A mouse model of acute kidney ischemia/reperfusion injury was established to conduct in vivo experiments. Oxygen–glucose deprivation (OGD) and cobalt chloride treatment of the HK-2 and glomerular endothelial cell (GENC) kidney cell lines were performed for the in vitro study. Reverse transcription–quantitative polymerase chain reaction, western blotting, and immunohistochemical staining were used to analyze NLRP2 expression levels. Knockdown of NLRP2 in cells was also performed, and cell apoptosis was detected using flow cytometry. NLRP2 was expressed in normal kidney tissues; however, its expression was significantly increased in the acute kidney injury model and in OGD-treated cells. Conversely, knockdown of NLRP2 reduced apoptosis of cells. These results suggested that NLRP2 was involved in kidney damage and may be an important target for treatment of acute kidney injury.
“What Do You Want to Do With the Leg?” A Critical Narrative Review of the Understandings and Implications of Disposal in the Context of Limb Amputations
Authors: Hanna Esmée
Published: June 2019

Amputation is seen to be a potentially distressing experience for patients and one which, for some patients, is seen as being akin to grief. Historically, medical professionals have alluded to the relevance of considerations of disposal of amputates after the process of amputation as being implicated in the psychological adjustment to amputation, yet limited understandings around disposal are evident. The disruption of bodily integrity by the process of amputation also presents a disruption of our norms around the disposal of human tissue, presenting challenges for how health care professionals can support patients through enacting their decisions around disposal. This narrative review article then explores the existing literature around disposal of amputates, drawing on literature from across the health and social sciences to examine what is known about disposal. It then argues that our considerations of disposal remain lacking despite the increasing incidence of amputation and the potential distress that not managing disposal can cause for some patients. It also examines the social implications of disposal and how limitations around disposal can itself reinforce the overlooking of disposal within the process and experience of amputation.
Browsing the Web for School: Social Inequality in Adolescents’ School-Related Use of the Internet
Authors: Weber Maximilian , Becker Birgit
Published: June 2019

This article examines whether social inequality exists in European adolescents’ school-related Internet use regarding consuming (browsing) and productive (uploading/sharing) activities. These school-related activities are contrasted with adolescents’ Internet activities for entertainment purposes. Data from the Programme for International Student Assessment (PISA) 2012 is used for the empirical analyses. Results of partial proportional odds models show that students with higher educated parents and more books at home tend to use the Internet more often for school-related tasks than their less privileged counterparts. This pattern is similar for school-related browsing and sharing Internet activities. In contrast to these findings on school-related Internet activities, a negative association between parental education and books at home is found with adolescents’ frequency of using the Internet for entertainment purposes. The implications of digital inequalities for educational inequalities are discussed.
Slope reduction osteotomy decreases ACL graft forces and reduces anterior tibial translation under axial load - a biomechanical study
Authors: Imhoff Florian B. , Mehl Julian , Obopilwe Elifho , Imhoff Andreas , Beitzel Knut
Published: June 2019

Aims and Objectives:

To perform an anterior closing wedge osteotomy by 10° for slope reduction and investigate the effect of axial load and anterior drawer on forces on ACL graft, strain and femoro-tibial kinematics in a native, ACL-deficient and reconstructed knee.

Materials and Methods:

Ten cadaveric knees with an increased native slope were selected for this study based on CT meas-urements. An anterior closing-wedge osteotomy was performed by 10° and fixed with an external fixator. Tibial axial load (200 N, 400 N) was applied, while the tibial side was mounted on a free mov-ing X-Y-table with open rotation in 30° of knee flexion. Additionally, an anterior drawer (134 N) was performed with and without axial load (200 N). Specimens underwent native testing, cut ACL, and reconstructed ACL with a standardized quadruple semi-t/gracilis-allograft. Each condition was ran-domly tested with native slope and reduced slope. Change of forces on ACL-graft (attached load-cell) and strain on native ACL (via DVRT) were recorded. Throughout testing, 3D motion tracking captured anterior tibial translation (ATT) and rotation versus the fixed femur.

Results:

Preoperative, specimens showed an averaged lateral and medial slope of (average ±SD) 10° ± 1.4°, and age 48.2 ± 5.8years. Slope reduction significantly decreased forces on ACL graft by 17% (p=0.001) at 200 N and by 33% (p=0.0001) at 400 N of axial load. Furthermore, ATT was significantly decreased after slope reduc-tion in native (p=0.01), cut (p=0.005), and ACL-graft (p=0.01) status. Strain in native ACL de-creased by 9.7 ± 0.13% (p<0.0001) after slope reduction without any load. However, anterior drawer without axial load maintained significantly higher anterior tibial translation (native-pre 4.12 ± 0.65 mm vs. native-post 5.82 ± 1.51 mm, cut-ACL-pre 9.35 ± 1.57 mm vs cut-ACL-post 12.0 ± 3.53 mm, ACL-recon-pre 4.60 ± 0.97 mm vs. ACL-recon-post 5.73 ± 1.45 mm) and significantly higher forces on ACL graft (p=0.0006) after osteotomy. When axial load was combined with anterior drawer no significant change on ATT after osteotomy was observed. Rotational analysis did show a significant effect in the ACL cut condition due to slope correction. Overall, native and reconstruct-ed ACL showed the same tibial kinematics throughout testing.

Conclusion:

In general, osteotomy lowered ACL graft force and ACL strain when the joint was axially loaded. Anterior tibial translation was reduced even in an ACL deficient knee. When anterior drawer was performed without axial load, ATT was higher after slope reduction in every condition.
Typical Pain Patters in Patients after total knee arthroplasty
Authors: Mathis Dominik T. , Hauser Antonia , Amsler Felix , Hirschmann Michael
Published: June 2019

Aims and Objectives:

About 20% of patients after total knee arthroplasty (TKA) are not satisfied nor pain free. After a challenging diagnostic workup it is not unusual that revision surgery becomes necessary. There is a general consensus that knee revision surgery should only be performed when the causes of the complaints are identified. In the clinical diagnostic process the detection of pain patterns that are typical for specific pathologies is paramount. Revision surgeons in clinical practice are well aware of some pain patterns but to date there is no study dealing with detection and identification of typical pain patterns in patients with painful TKA. The purpose of this study is the detection and definition of typical pain patterns in patients with painful TKA and the assignment to typical pathologies such as instability, stiffness, loosening, patellofemoral overstuffing and mechanical dysfunctions.

Materials and Methods:

A consecutive number of 129 patients, which were seen in the consultation at a specialized knee centre between 2012 and 2017 due to painful primary knee arthroplasty and whose diagnostic workup resulted in revision surgery were included. Defined criteria were retrospectively assessed from pre-existing patient documentation, statistic analysis (chi-squared test) and the assignment to the underlying pathology was performed. The criteria include localisation, intensity and character of pain, position and type of the prosthetic components, postoperative course, indication for revision surgery and demographic data such as age of the patient at primary surgery, sex, time between primary and revision surgery, socioeconomic status.

Results:

Typical pain patterns were defined and assigned to specific pathologies. Significant correlation was shown between localisation, intensity and character of pain and demographic data, type and position of the prosthetic components, surgical technique as well as the underlying cause for revision surgery such as instability, stiffness, loosening, patellofemoral overstuffing and mechanical dysfunction.

Conclusion:

The detection and definition of typical pain patterns in patients with pain after TKA and the assignment of identified pathologies will be applied in the improvement of the diagnostic process. Only when the exact cause of pain is determined, the therapy can be successful. The results of this study allow improving the clinical diagnostic process of patients with pain after TKA and help to enhance the indications for possible revision surgery.
Good correlation of the maximal relative bone tracer uptake in SPECT/CT and intraoperative findings of chondral lesions graded with the ICRS
Authors: Schiapparelli Filippo-Franco , Ammann Nora , Rasch Helmut , Amsler Felix , Hirschmann Michael
Published: June 2019

Aims and Objectives:

It is a pertinent question if SPECT/CT is able to reflect the cartilage status of the knee. Hence, it was the purpose of this study to evaluate the correlation between maximal relative bone tracer uptake (mrBTU) of preoperative SPECT/CT and intraoperative findings of chondral lesions assessed with the International Cartilage Repair Society (ICRS) scoring.

Materials and Methods:

Thirty-three consecutive patients (male: female=11: 22; mean age ± standard deviation 61±15) with bi- or tri-compartmental osteoarthritis of the knee who underwent SPECT/CT before total knee arthroplasty (TKA) were included. The knee was divided into 11 anatomical regions. In each region, mrBTU values were calculated twice by two observers within a six weeks interval. The intraclass correlation coefficient (ICC) was calculated and mean values were used. Intraoperatively, for every region the cartilage status with regards to ICRS score was assessed. A non-parametrical Spearman’s correlation was performed. A factor analysis was performed on mrBTU and ICRS scores (p<0.05).

Results:

The ICC presented excellent correlations. The Spearman’s correlation performed separately on mrBTU and ICRS scores showed diffuse significant correlations which were especially strong between regions of the same knee compartment (p < 0.01). The Spearmann correlation calculated between rmBTU and IRCS scores evidenced very strong correlations on the medial femoral condyle, on the ventral two third of the medial tibia plateau (p < 0.01) and good correlations on the proximal femoral trochlea and on the medial patellar facet (p < 0.05).

Conclusion:

A highly significant correlation between SPECT/CT and intraoperative findings was demonstrated. The use of an objective measure as the rmBTU for osteoarthritis could overcome the limit of the subjectivity of MRI findings.
No growth disturbance after trochleoplasty for recurrent patellar dislocation in adolescents with open growth plates
Authors: Williams Sean Robert , Nelitz Manfred
Published: June 2019

Aims and Objectives:

Trochlear dysplasia is the most important risk factor to patellofemoral instability in adolescents, therefore trochleoplasty to reshape the trochlear groove is the treatment of choice in patients with severe trochlear dysplasia. However, in the presence of open growth plates there is a potential risk of injury of the distal femoral growth plate and subsequent growth disturbance. Therefore, most authors do not recommend trochleoplasty in skeletally immature patients. The effect of trochleoplasty on femoral growth when performed before closure of the distal femoral physis remains unclear. The hypothesis of the study was, that In patients with open growth plates and an expected growth of less than two years trochleoplasty does not cause growth disturbance of the distal femur.

Materials and Methods:

18 consecutive adolescents (18 knees) with open physes and severe trochlear dysplasia underwent trochleoplasty. Pre- and postoperative radiographic examination included AP and lateral views to assess leg axis and patella alta. Preoperatively a radiograph of the left hand was performed to measure skeletal age. MRI was performed to evaluate trochlear dysplasia and tibial tubercle-trochlear groove (TT-TG) distance. Evaluation included pre- and postoperative physical examination with evaluation of leg length and leg axis, Kujala score, Activity Rating Scale (ARS) and Tegner activity score.

Results:

The average age at the time of operation was 12.6 y (range, 12.2 - 13.3) in girls and 14.5 y (14.0 - 15.4) in boys. The average follow-up after operation was 2.3 years after surgery (range, 2.0 - 3.0 years). At follow-up in all patients the growth plates of the knee were closed. Impairment of growth of the distal femur was neither found clinically nor radiographically. No recurrent dislocation occurred. The median Kujala score and median VAS showed significant improvement (p < 0.01). The activity level according to the Tegner activity score did not change statistically significant.

Conclusion:

In this study, trochleoplasty as a treatment for patellofemoral instability in patients with open physes and an expected growth of not more than two years showed good clinical results without redislocation and no growth disturbance. Therefore, in selected adolescent patients with severe trochlear dysplasia trochleoplasty can be safely performed up to two years before the projected end of growth.
Geometry of Torsional Malalignment Syndrom: Trochlear Dysplasia but not Torsion Predicts Lateral Patellar Instability
Authors: Balcarek Peter , Vogel Dennis
Published: June 2019

Aims and Objectives:

To analyze parameters of limb malalignment and patellar tracking in patients with torsional malalignment syndrome presenting with clinical symptoms of either patellofemoral pain or patellar instability.

Materials and Methods:

Between April 2015 and July 2017, 428 patients were treated for lateral patellar instability (LPD), and 333 patients were treated for patellofemoral pain syndrome (PFPS). Sixty-two patients (14.5%) with patellar instability (LPD group) and 29 patients (8.7%) with patellofemoral pain (PFPS group) had additional torsional malalignment and were included in this study. All patients underwent magnetic resonance imaging assessment of torsional alignment and patellar tracking, including femoral antetorsion, tibial torsion, knee rotation, tibial tuberosity-trochlear groove distance, tibial tuberosity-posterior cruciate ligament distance, Dejour’s classification of trochlear dysplasia, lateral trochlear inclination angle, and patellar height

Results:

Groups differed significantly in terms of trochlear dysplasia (p<0.001), lateral trochlear inclination angle (p<0.001) and tibial tuberosity-trochlear groove distance (p=0.0167) but did not differ in terms of femoral torsion (LPD group 20.02° +/- 8.8°; PFPS group 20.03° +/- 7.91°; p=0.8545), tibial torsion (LPD group 39.53° +/- 9.23°; PFPS group 41.24° +/- 7.28°; p=0.3616), and knee rotation (LPD group 10.42° +/- 5.16°; PFPS group 8.48° +/- 7.81°; p=0.0163). Only measures of coronal alignment were positively correlated. This was also true for the tibial tuberosity-trochlear groove distance and knee rotation but not for any other parameters of torsional limb alignment. Trochlear dysplasia (type B-D) was identified as the only significant predictor of patellar instability.

Conclusion:

Torsional malalignment syndrome, represented in this study by two clinical entities - PFPS and LPD - is not characterized by a typical constellation of different malalignment parameters. Between groups, parameters differed significantly only in terms of trochlear dysplasia and the tibial tuberosity-trochlear groove distance, with trochlear dysplasia (type B-D), but not torsion, identified as predictor of lateral patellar instability.
Persistent traumatic peroneal nerve palsy - surgical treatment by neuromusculotendinous gastrocnemius muscle transfer
Authors: Hoppert Matthias , Dornseifer Ulf
Published: June 2019

Aims and Objectives:

Common peroneal nerve palsy is a relatively frequent complication in trauma of the knee and lower extremity. Persistent traumatic peroneal nerve palsy is usually treated by tendon transfer. A surgical concept for the treatment by neurotized lateral gastrocnemius muscle transfer is demonstrated with the aim of restoring active voluntary dorsiflexion. The indication, the surgical technique and the results obtained in two own cases with review of the literature are presented.

Materials and Methods:

Surgical technique: The lateral head of the gastrocnemius muscle is transferred to the tendons of the anterior tibial muscle group. The intact proximal end of the deep peroneal nerve is transpositioned to the tibial nerve of the gastrocnemius muscle by microsurgical technique. The transferred muscle is reinnervated by nerve coaptation between the undamaged proximal part of the deep peroneal nerve and the motor branch of the tibial nerve supplying the gastrocnemius muscle. The key steps of the surgical technique are described.

Results:

Short term results of the own cases appeared excellent. In both patients the transferred gastrocnemius muscle showed signs of reinnervation within 6 months after the operation. The patients achieved stable functional gait, voluntary movement of the transferred muscle and active range of motion of about 40 degrees. The early clinical results are compared with the clinical series in the literature since 1994.

Conclusion:

Early clinical results after the neuromusculotendinous gastrocnemius muscle transfer appear highly successful. They still need to be compared with conventional tendon transfer procedures. The described operative approach offers some advantages compared with other methods in the reconstruction of a drop foot secondary to traumatic common peroneal nerve palsy in a well-selected group of patients. In contrast to the commonly used treatment of tibialis posterior muscle transfer no reeducation of the transferred muscle is needed. We review the indications and limitations of this technique.
Functional Outcome of Revision Osteosynthesis after failed surgical treatment of patellar fractures
Authors: Müller Elena , Frosch Karl-Heinz
Published: June 2019

Aims and Objectives:

Patellar fractures account for approximately 1% of all skeletal fractures. They are rare, but due to the crucial function of the patella in the extensor mechanism of the knee they can lead to a serious impairment. New data are revealing functional impairment remains common even with improved surgical techniques. The aim of this study is to asses the functional outcome of patients after revision surgery in case of secondary fracture dislocation or remaining articular incongruity.

Materials and Methods:

The study was designed as a retrospective observatory study. We included all patients who underwent a revision surgery because of a remaining articular incongruity or a secondary fracture dislocation or re-fracture from January 2010 until december 2016.

Results:

Sixteen patients of mean age 51,8 years were included in the study with a mean follow-up period of 28,8 months. Fifteen patients had AO type C fractures, within ten a C3 fracture. Thirteen were initially treated with tension band wiring via k-wires or cannulated screws. The reason for a revision surgery were 5 times a remaining articular incongruity, 11 times a secondary fracture dislocation or re-fracture. We analysed pain, satisfaction, range of motion, Böstman-Score, Tegner-Score and KOOS and could extract follow-up data from 15 of the patients. All fractures healed, no articular incongruity remained. Mean pain measured with the visual analogue scale (0-10) was at rest 0,57 (range 0-3,5), on exertion 2,79 (range 0-8). The measurement of the range of motion compared with the opposite knee showed a complete extension. Mean Flexion was 120°, in the opposite knee 136° (p = 0,05). Mean postoperative Böstman-Score and Tegner-Score were 25,11 (good, max. 30) and 78,67 (moderate, max. 100). KOOS: symptoms 66,8 points, pain 77,55 points, ADL 75,67 points and qualitiy of life 56,25 points.

Conclusion:

Early revision surgery in case of secondary fracture dislocation, re-fracture or remaining articular incongruity leads to statisfactory functional outcomes. Furthermore in case of complexe fractures the tension band wiring technique shouldn’t be the first choice, alternatives like the plate osteosynthesis should be considered.
Clinical outcome 5 years after Dynamic Intraligamentary Stabilization of acute ACL ruptures
Authors: Kösters Clemens , Glasbrenner Johannes , Raschke Michael J. , Lenschow Simon , Herbort Mirco , Schliemann Benedikt
Published: June 2019

Aims and Objectives:

Dynamic Intraligamentary Stabilisation (DIS) is an anterior cruciate ligament (ACL) preserving surgical procedure for acute ACL injuries. A braided suture and a threaded sleeve containing a preloaded spring fixed into the proximal tibia provides continuous biomechanical stability. In combination with mircofracturing, self-healing of the ACL is promoted.

Materials and Methods:

Between January and November 2013 65 patients with an acute ACL rupture treated by Dynamic Intraligamentary Stabilisation (DIS) were included in this prospective study. Inclusion criteria were acute ACL injury, a positive Lachman test compared to the healthy contralateral side and closed growth plates. The following demographic patient data was preoperatively recorded: age, gender, weight, activity scores (Tegner, Lysholm, IKDC), type of injury, ap-translation of both knees measured by KT-1000 or Rolimeter, knee function and prior surgeries to the knees. Furthermore pivot shift test, acl rupture type, days until surgery, operating time, pre-existing pathologies and concomitant injuries were detected during surgery. The result of the reconstruction was assessed by rating it as anatomical, almost anatomical or non-anatomical. Patients were followed-up at 6 weeks, 6 months, 1 year, 2 years and 5 years after surgery. Patient satisfaction was detected recorded on a visual analog scale (VAS) scale from 0-10.

Results:

34 men and 31 women were included. Mean age was 32.6 years (range 15 to 62 years). More than 70% of the injuries were soccer or handball associated. In 24 patients meniscal tears had to be repaired and in 4 patients cartilage damages had to be treated. All patients could be examinated 5 years after surgery. Within the follow up period 8 reruptures occured which were treated by one-step ACL reconstruction using an ipsilateral semitendinosus autograft. 4 patients had to be revised performing an arthrolysis due to extension deficit. At 5 years, Tegner Score averaged at 4.9 (compared to 5.5 pre-operatively). IKDC had an average of 90 (98). Lysholm score was at 95 (99). Patient satisfaction was 8.5.

Conclusion:

With the use of DIS, ACL preserving restoration of knee joint kinematics and mid-term survival of the repaired ACL after acute acl rupture can be achieved. Perioperative morbidity is reduced since harvesting of tendon grafts is not required. In case of recurrent instability or rerupture, conventional ACL reconstruction can still be performed. Knee function scores have shown a good rehabilitation and return to pre-trauma activity levels. However, long-term results are required to confirm safety and effectivity of the presented technique.
The “Apple-Bite-Fracture”: ACL rupture combined with posterolateral tibia plateau fracture
Authors: Menzdorf Leif , Drenck Tobias , Preiss Achim , Akoto Ralph , Krause Matthias , Frosch Karl-Heinz
Published: June 2019

Aims and Objectives:

Anterior cruciate ligament (ACL) ruptures are often concomitated by posterolateral bone bruise in the MRI. This is caused by a ventral subluxation of the tibia and impact of the femur in the posterolateral tibia plateau. In some cases, this impact causes a fracture of the posterolateral tibia plateau, the so-called Apple-Bite-Fracture. The increased posterior slope can cause additional instability and has to be considered as a risk factor for ACL failure. In this study we investigated the short term clinical outcomes of patients with this combined injury.

Materials and Methods:

Retrospective study of 14 patients (mean age 46 ± 12,3) (8 male, 6 female) with a mean follow up of 23,75 months. Different treatment strategies were analyzed. The clinical evaluation included visual analog score (VAS) increasing from 0-10 for Pain, IKDC Score, Rasmussen score as well as a clinical evaluation.

Results:

First analysis of the treatment options revealed a non-uniformed therapy strategy. In three patients the ACL tear was treated nonsurgical. In 11 patients the ACL tear was addressed surgical: six times the ACL was reconstructed with hamstring tendon graft, two times the ACL was sutured. Two patients treated with a non-reconstructive technique to promote healing (“healing response”). In one patient a tibial eminence fracture was fixated with a screw. The fracture of the posterolateral tibia plateau was in nine cases minimally invasive reduced and fixated with a screw osteosynthesis in jail technique. Two patients needed posterior buttress plate. Three times the large bone defect has been augmented with autologous bone graft from the pelvis. The postoperative clinical testing did not reveal any persisting knee instabilities. All patient had a non-limited ROM. No significant differences in ROM in comparison to the contralateral knee was seen. One patient reported persisting knee pain (VAS 3). All other patients reported no pain (VAS 0). Subjective IKDC score was 78,18 (71,3 - 83,9; ± 5,68). Clinical Rasmussen scores ranged from 27 to 30 (mean 27, ± 3,0). Rasmussen radiological results ranged from 16 to 18, mean 16,67 (± 1,15).

Conclusion:

Despite a very small patient number and leck of statistical power the new patient-spedific mini-metal implant seems to be a good options fort he treatment of middle-aged patients who already underwent frustane cartilage surgery. In these relatively rare caes early unicompartimental arthroplasty can be prevented. Further clinical studies with larger patient collectives have to prove the effectiveness of this new technique.
Prevalence and Patterns of Health Care Use Among Poor Older People Under the Livelihood Empowerment Against Poverty Program in the Atwima Nwabiagya District of Ghana
Authors: Agyemang-Duah Williams , Peprah Charles , Arthur-Holmes Francis
Published: June 2019

In spite of the growing literature on prevalence and patterns of health care use in later life globally, studies have generally overlooked subjective standpoints of vulnerable Ghanaian older people obstructing the achievement of the United Nations’ health-related Sustainable Development Goals. We examined the prevalence and patterns of health care use among poor older people in the Atwima Nwabiagya District of Ghana. Cross-sectional data were obtained from an Aging, Health, Lifestyle and Health Services Survey conducted between June 1 and 20, 2018 ( N = 200). Chi-square and Fisher’s exact tests were carried out to estimate the differences between gender and health care utilization with significant level of less than or equal to 0.05. Whereas, 85% of the respondents utilized health care, females were higher utilizers (88% vs. 75%) but males significantly incurred higher health care expenditure. The majority utilized health services on monthly basis (38%) and consulted public health care providers (77%). While 68% utilized services from hospitals, most sourced health information from family members (54%) and financed their health care through personal income (45%). The study found that the Livelihood Empowerment Against Poverty grant played a little role in reducing health poverty. Stakeholders should review social programs that target poor older people in order to improve their well-being and utilization of health care.
Effect of a 10-Week Aquatic Exercise Training Program on Gross Motor Function in Children With Spastic Cerebral Palsy
Authors: Akinola Bolarinwa Isaac , Gbiri Caleb Ademola , Odebiyi Daniel Oluwafemi
Published: June 2019

Introduction. Cerebral palsy (CP) is caused by an injury to the developing brain, and abnormal gross motor function is a hallmark of CP. Properly structured exercises on land have been reported to be effective in improving functional performance in children with CP while only few have been documented on aquatic therapy. Objective. To investigate the effect of a 10-week aquatic exercise training program on gross motor function in children with spastic CP. Methods. Thirty participants aged 1 to 12 years were randomized into the experimental and control groups. Both groups received manual passive stretching and functional training exercises, depending on their level of motor impairment, either in water (temperature 28°C to 32°C) or on land. Each exercise training session lasted for about 1 hour 40 minutes, twice per week for 10 weeks in both groups. Measurement of gross motor function was done using Gross Motor Function Measure (GMFM-88) at baseline and after 4 weeks, 8 weeks, and 10 weeks of intervention. Both groups were compared for differences in change in gross motor function using Mann-Whitney U test. The level of significance was set at P < .05. Results. Only the experimental group showed significant improvement ( P < .05) in all dimensions of gross motor function except for walking, running, and jumping ( P = .112). Statistically significant difference ( P < .05) was found between both groups for all dimensions of gross motor function after 10 weeks of intervention. Conclusion. Aquatic exercise training program is effective in the functional rehabilitation of children with spastic CP.
Clinical Evaluations Have Low Sensitivity for Identifying Preterm Infants in a Clinical Trial in a Limited Resource Setting
Authors: Buchwald Andrea G. , Teguete Ibrahima , Doumbia Moussa , Haidara Fadima C. , Coulibaly Flanon , Diallo Fatoumata , Sow Samba O. , Blackwelder William C. , Tapia Milagritos D.
Published: June 2019

Preterm birth is a primary outcome of interest in maternal vaccination trials but determination of gestational age is challenging in limited-resource settings. This study compares the New Ballard Score and fundal height measurements with the current standard of early ultrasound for sensitivity of predicting preterm birth. A trial of maternal influenza vaccination was conducted in Bamako, Mali. The New Ballard Score and fundal height were collected on 4038 infants born in the trial, ultrasound data were available for 1893 of those infants. New Ballard Score and fundal height were compared, consecutively, to all ultrasound results, early ultrasound results from the first trimester, and the date of last menstrual period for estimation of gestational age. Sensitivity of the New Ballard Score for identifying preterm infants was 0.33 compared with early ultrasound and 0.1 compared with the last menstrual period based estimates of gestational age. Sensitivity of low birth weight alone was 0.43 compared with early ultrasound. New Ballard Score estimated gestational age within 1 week of ultrasound more frequently than fundal height (53% compared with 7.6%, respectively) yet New Ballard Score identified few infants as preterm (1.8% vs 5.8% by early ultrasound), and was biased toward categorizing low birth weight infants and infants requiring hospitalization as preterm. New Ballard Score is not an ideal measure for identifying preterm births in low-resource settings. Despite the time and cost of training required for correct measurement of New Ballard Score, measurement of low birth weight alone performed better than New Ballard Score for identifying preterm infants.
Transforming Mission Theology
Authors: Whiteman Darrell
Published: June 2019

Charles Van Engen’s book Transforming Mission Theology is reviewed, highlighting the integration of biblical, theological, contextual, and personal domains in the development of mission theology. The book is noteworthy for its balance of diverse perspectives, its depth of insight, its awareness of the impact of globalization on the local church, and its balance of ecumenical and evangelical perspectives.
How European Is Pentecostalism?
Authors: Atkinson William P.
Published: June 2019

Acknowledging that in Europe, Pentecostalism is relatively weak, this article explores the degree to which Pentecostalism may nevertheless be European. It does so in three respects. First, it explores Pentecostalism’s prehistory and history, finding distinct European motifs there. Then, it considers the place of African Pentecostalism in today’s Europe, considering the limited success of so-called reverse mission. Lastly, it considers the possible future openness of Europe to the Pentecostal message, noting an observed change in mind-set in a continent moving toward some form of “postsecularism.”
Prevalence of BTK and PLCG2 mutations in a real-life CLL cohort still on ibrutinib after 3 years: a FILO group study
Authors: Quinquenel Anne , Fornecker Luc-Matthieu , Letestu Rémi , Ysebaert Loïc , Fleury Carole , Lazarian Grégory , Dilhuydy Marie-Sarah , Nollet Delphine , Guieze Romain , Feugier Pierre , Roos-Weil Damien , Willems Lise , Michallet Anne-Sophie , Delmer Alain , Hormigos Katia , Levy Vincent , Cymbalista Florence , Baran-Marszak Fanny
Published: June 2019

Mutational analyses performed following acquired ibrutinib resistance have suggested that chronic lymphocytic leukemia (CLL) progression on ibrutinib is linked to mutations in Bruton tyrosine kinase (BTK) and/or phospholipase Cγ2 (PLCG2) genes. Mutational information for patients still on ibrutinib is limited. We report a study aimed to provide a “snapshot” of the prevalence of mutations in a real-life CLL cohort still on ibrutinib after at least 3 years of treatment. Of 204 patients who initiated ibrutinib via an early-access program at 29 French Innovative Leukemia Organization (FILO) centers, 63 (31%) were still on ibrutinib after 3 years and 57 provided a fresh blood sample. Thirty patients had a CLL clone ≥0.5 × 109/L, enabling next-generation sequencing (NGS); BTK and PLCG2 mutations were detected in 57% and 13% of the NGS samples, respectively. After median follow-up of 8.5 months from sample collection, the presence of a BTK mutation was significantly associated with subsequent CLL progression (P = .0005 vs no BTK mutation). Our findings support that mutational analysis should be considered in patients receiving ibrutinib who have residual clonal lymphocytosis, and that clinical trials are needed to evaluate whether patients with a BTK mutation may benefit from an early switch to another treatment.