bluuebunny/crossref_metadata_2025_split huggingface dataset:
Folate and vitamin B12 status and their relation to hematological indices in healthy adults of Iranians: Azar cohort study
Authors: Azimi Sona , Faramarzi Elnaz , Sarbakhsh Parvin , Ostadrahimi Alireza , Somi Mohammad Hossein , Ghayour Mousa 
Published: December 2018

Background: Folate and vitamin B12 are essential micronutrients, the deficiency of which can be associated with public health problems worldwide. Aim: The aims of this study were to assess the folate and vitamin B12 status of healthy adults and the effect of gender differences on their deficiency using serum folate, vitamin B12 and red blood cell (RBC) folate as biomarkers and their relation to hematological indices. Methods: This study was a part of the Azar cohort study, which is designed as a noncommunicable disease survey in the population of Shabestar, East Azerbaijan, Iran. A total of 95 healthy adults (35 men, 60 women) were chosen according to exclusion criteria and assessed using demographic characteristics and blood sampling. Results: Low concentrations of serum folate, vitamin B12 and RBC folate were detected in 16.8%, 61.1% and 40% of all subjects, respectively. Prevalence of low serum folate and vitamin B12 was higher in men than women (25.7% versus 11.7% for serum folate, 77.1% versus 51.7% for serum vitamin B12).A significant positive correlation was found between hemoglobin and serum folate, vitamin B12 and RBC folate concentrations ( r = 0.279, 0.335, 0.228, respectively). No statistically significant correlation between mean corpuscular volume and serum folate, vitamin B12 and RBC folate was seen ( r = –0.049, –0.030, –0.016, respectively). Conclusions: There was a high prevalence of low folate and vitamin B12 concentrations in our community. Regarding the impact of these two vitamins deficiency on overall health, we suggest further investigations with more participants. In addition, monitoring hematological indices could be useful in people with folate and vitamin B12 deficiency.
Trabecular Titanium acetabular cups in hip revision surgery: mid-term clinical and radiological outcomes
Authors: De Meo Federico , Cacciola Giorgio , Bellotti Vittorio , Bruschetta Antongiolio , Cavaliere Pietro 
Published: December 2018

Introduction: Severe acetabular bone loss during revision hip arthroplasty can be restored with different surgical techniques. Best results have been observed using porous tantalum cementless cups. Trabecular Titanium (TT) cups were designed to reproduce the structure, mechanical and biological characteristics of trabecular bone. Few clinical studies have been published with these cups. The aim of this study is to evaluate the clinical and radiological outcome of patients with large acetabular defects (Paprosky IIb or higher) revised using TT cups. Materials and methods: 64 consecutive patients who underwent revision for total hip arthroplasty (THA) between 2011 and 2015 at our institution were enrolled. All were classified as Paprosky IIb, IIc, IIIa and IIIb. Periprosthetic joint infections and fractures were not included in this study. Radiographic and clinical (Harris Hip Score (HHS)) outcomes were evaluated. Kaplan-Meyer survivorship curve was performed. Results: Complete data of 58 patients (mean follow-up 48.3 months) were analysed. 6 patients underwent a further revision (10.3%). Causes of re-revision were instability (5.2%), infection (3.4%) and aseptic loosening (1.7%). No radiolucent lines or signs of migration were observed. Survivorship was 94.8%. HHS Improved from a mean of 36.5–83.7. Discussion: TT cups demonstrated encouraging results at mid-term follow-up. Cup modularity represented a helpful tool to restore hip rotation centre and to reduce the risk of dislocation. The capacity of trabecular titanium to induce bone growth and the versatility of modularity, make the Delta TT System a very useful aid for surgeons who are more frequently faced with complex revision.
Adverse reaction to metal debris after small-head diameter metal-on-metal total hip arthroplasty: an increasing concern
Authors: D’Angelo Fabio , Tanas Davide , Gallazzi Enrico , Zagra Luigi 
Published: December 2018

Introduction: Failures due to adverse reaction to metal debris (ARMD) have become an area of common focus among surgeons performing hip replacements. Several authors have reported data on the prevalence of these masses, in both symptomatic and asymptomatic patients after either large-diameter head metal-on-metal (MoM) total hip arthroplasty (THA) or hip resurfacing arthroplasty, with a large variability of rate. To our knowledge, few data are reported on the association of this lesion with the use of small-head diameter MoM. Methods: 15 hips that were revised for ARMD in small-head MoM THA were included in this study. We focused our attention on the difficulties of diagnosis and treatment and also on the histologic aspects of the harvested pathologic tissue. Results: The histological examination of our cases showed a presence of lymphocytic infiltrate suggesting a delayed hypersensitivity reaction to the metal of type IV (ALVAL), but different from each other in term of the prevalence of the cellular component. Osteolysis and severe soft tissue damage were also observed. Revision resulted in remission of the lesion and successful implant. Conclusions: Our observation suggests that the evidence of ARMD should be considered even in case of small-head MoM arthroplasty and therefore these patients should be followed scrupulously with 2nd level diagnostic tools such as magnetic resonance imaging with metal artifact reduction sequence (MARS-MRI) and metal ion levels at least once. Further investigations are necessary to establish the real prevalence of this phenomenon in the whole population of small-head MoM THAs.
Stemless hip arthroplasty versus traditional implants: a comparative observational study at 30 months follow-up
Authors: Logroscino Giandomenico , Donati Fabrizio , Campana Vincenzo , Saracco Michela 
Published: December 2018

Introduction: The aim of this retrospective case-control study is to evaluate clinical and radiographic results of short stems compared with traditional hip prostheses. Methods: 46 short stems (SS) and 50 traditional stems (TS) were selected. All the stems were implanted by the same surgeon using posterior approach because of primary osteoarthritis, post-traumatic osteoarthritis and avascular necrosis. All the patients were compared clinically by Harris Hip Score (HHS), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), visual analogue scale (VAS), 12-item Short Form Health Survey (SF-12F/M) and radiographically (offset, CD angle, limb length discrepancy, cup inclination, subsidence, osseointegration, heterotopic ossification). Radiographic evaluations were carried out by 3 different blinded surgeons. A statistical analysis was performed (chi-square, t-test, Mann-Whitney). Results: At a mean follow-up of 30 months all the implanted stems were well-positioned and osseointegrated. In both groups there was a marked improvement in pain ( p < 0.001) with a statistically significant advantage in the SS group for WOMAC (90.8 vs. 87.5; p = 0.02) and in part for HHS (93 vs. 91.7; p = 0.18). The radiographic evaluations, with high concordance correlation between the 3 blinded surgeons (ICC consistently >0.80), showed no significant differences in the restoration of the articular geometry, with a reduction of cortical hypertrophy (2% SS vs. 7% TS) and periprosthetic stress-shielding ( p < 0.05) in the SS group. On the other hand, SS were more related to limb length discrepancy (61% vs. 33%; p < 0.05). No major complications were recorded in the 2 groups. Conclusion: Short stems were shown to be comparable or better than traditional implants at short-term follow-up.
Is there still a role for threaded acetabular cups?
Authors: Gala Luca , Boisio Francesca , Calanna Filippo , Lonati Fiorello , Marelli Bruno M 
Published: December 2018

Introduction: Total hip arthroplasty (THA) is 1 of the most common procedures in orthopaedic surgery. Different options and implants are currently available. Uncemented hip cups need primary stability for bone ingrowth, the use of screws is required when the desired stability is not achieved. Another option is the use of a hemispherical threaded cup with enhanced primary stability. The purpose of our study was to compare the results of a 3rd-generation threaded cup versus a press-fit cup with a long track record. Materials and methods: A consecutive series of 300 THAs performed by 2 surgeons was retrospectively reviewed, 150 press-fit cups and 150 screwed cups. Minimum follow-up 27 months; maximum 78 months (mean 52.5 months). The primary endpoint was a stable and painless THA, secondary endpoints included Hip disability and Osteoarthritis Outcome Score, Junior and radiographic evaluation. Results: Preliminary results showed no statistically significant differences between the 2 groups for all the evaluated parameters, the number of early mechanical loosening was higher for press-fit cups, but this value was not statistically significant. At a mean follow-up of 52.5 months 1 cup revision (0.3%) was seen in the screwed cup group and 2 (0.6%) in the press-fit cup; these results were not statistically significant. Discussion and conclusion: The main concern for screwed cups is the greater bone loss and possible removal difficulties during revision surgery. This study has some limitations, in particular regarding follow-up, but is still ongoing. Our results showed no difference between the 2 systems.
ABO system is not associated with proximal femoral fracture pattern in Southern Italy
Authors: Toro Giuseppe , Lepore Federica , Cicala Stefano D , Concilio Pietro , Calabrò Giampiero , Toro Antonio , Maffulli Nicola 
Published: December 2018

Introduction: The mechanism that leads to a given fracture pattern is not understood. Heredity could act in this field through the ABO system. We investigated the relationship between ABO blood system and hip fracture pattern in a population from Southern Italy. Methods: Hip fractures were identified through a registry evaluation of the activity of a level I Hospital, and subsequently classified in ‘intracapsular’ or ‘extracapsular’ according to their anatomical location. Information on these patients’ ABO blood type was collected and compared with general population data from the report on blood donors of the Salerno division of Italian Blood Volunteers Association (AVIS). Results: 590 hip fractures were included (414 extracapsular, 176 intracapsular) and compared with 709 blood donors. Fractured patients presented a blood group A more often and blood group O less often than the AVIS population ( p A vs. non-A = 0.0033; p O vs. non-O = 0.0024). None of the ABO blood groups were associated with fracture pattern ( p O vs. non-O = 0.5858, p A vs. non-A = 0.409; p B vs. non-B = 0.253; p AB vs. non-AB = 0.212). The rhesus factor was not associated the fracture pattern ( p = 0.34). Conclusions: The ABO blood type could play a role as a risk factor for proximal femoral fractures, but in our population its relevance in influencing the fracture pattern is unclear.
Many caregivers of persons with memory loss or Alzheimer's disease are unaware of the abilities of their persons with AD to recall their drugs and medical histories
Authors: Ala Thomas A , Simpson GaToya , Holland Marshall T , Tabassum Vajeeha , Deshpande Maithili , Fifer Amber 
Published: December 2018

Background Caregiver awareness of the abilities of those they care for has much practical importance, especially from the safety standpoint. Objectives To determine whether the caregivers of persons with memory impairment or Alzheimer's disease know if their persons are able to recall their own drugs and medical histories. Method Persons with prodromal or probable AD (persons with AD) and their caregivers who were visiting our medical school's neurology and internal medicine clinics for routine follow-up care were recruited on the days of their appointments. Sixty-four caregiver-person with AD dyads were recruited. We first asked the caregivers to predict the ability of their persons with AD to answer questions about their drugs and medical histories. We then asked the persons with AD the questions to determine the accuracy of their caregivers' predictions. Results Considering the caregivers of those with Mini-Mental State Exam scores ≥24, 41% incorrectly predicted whether their persons with AD could recall the number of drugs they were taking, 24% incorrectly predicted whether they could recall the names of the drugs, and 34% incorrectly predicted whether they could recall why they were taking the drugs. Most of the caregivers' errors were overestimations. As expected, the persons with AD themselves had much difficulty in answering the questions; only 30% could recall the number of drugs they were taking, only 14% could recall the names of the drugs, and only 16% could recall why they were taking the drugs. Conclusions Many caregivers of persons with memory impairment or AD are unaware of their persons' inability to recall their drugs and medical histories. Particularly concerning is the relatively high frequency of caregiver overestimations of the abilities of their persons with AD, which highlights a safety concern and presents an opportunity for caregiver education.
Hispanic Dementia Family Caregiver’s Knowledge, Experience, and Awareness of Self-Management: Foundations for Health Information Technology Interventions
Authors: Lucero Robert J. , Jaime-Lara Rosario , Cortes Yamnia I. , Kearney Joan , Granja Maribel , Suero-Tejeda Niurka , Bakken Suzanne , Luchsinger Jose A. 
Published: December 2018

Purpose: As a first step toward developing a web-based Family-Health Information Management System intervention, we explored Hispanic dementia family caregiver’s knowledge, use, and awareness of self-management principles and skills to address health and health care needs for themselves and the person with dementia (PWD). Method: Twenty caregivers and 11 caregiver counselors attended an English or Spanish language focus group ranging from 4 to 6 participants. We conducted a directed content analysis informed by Lorig and Holman’s conceptualization of self-management. Results: A complement of six skills (i.e., problem solving, decision making, resource utilization, patient–provider partnership, action planning, and self-tailoring) to achieve one of three tasks (i.e., emotional, medical, and role management) can fully represent Hispanic dementia family caregivers’ ability to self-manage health and health care needs. While not prominent in our study, caregivers and caregiver counselors pointed out existing and potential uses of personal consumer technology to schedule reminders and search for resources. Discussion: A broad conceptualization of self-management may be necessary to understand Hispanic dementia family caregiver’s ability and needs to address emotional, medical, and role challenges of caregiving. Conclusions: These findings and advances in the use of consumer health information technology support the development of self-management caregiver interventions.
Arthroscopic treatment of internal snapping hip
Authors: Magi Gonzalo J. , Carucci Juan Pablo , Bergués Sebastián 
Published: December 2018

Introduction: Internal snapping hip syndrome (ISHS) is caused by the iliopsoas tendon snapping over either the iliopectineal ridge or the anterior femoral head. Excellent results are achieved only with activity modification, rest, and stretching the iliopsoas muscle. The literature favors iliopsoas tendon release if conservative therapy fails. There is little evidence about the gold standard of this condition. Objective: Describe clinical results, complicactions and recurrence rate of arthroscopic treatment of ISHS. Methods: We included all patients who failed conservative treatment and were treated with arthroscopy for ISHS between March 2012 and March 2018. Patients with less than 2 years of follow up and previous surgery on the hip were excluded. We performed Ilizariturri´s technique with a transcapsular endoscopic release in central compartment. We registered modified Harris hip score (MHHS), Hip outcome score activity of daily living (EHOSDL), patients satisfaction, recurrence rate and complications. Results: Eight patients were included. Average follow up was 36 months (range 24-60 months). MMHS improved from preoperative average score of 70 (range 62-72) to postoperative average of 93 (range 92 to 96). Average EHOSDL improvement was 30% (from 55% preoperative to 85% postoperative). All patients had excellent results. Average patient satisfaction was 8 (range 7-9). We had no recurrence or complications. Conclusion: Arthroscopic treatment of ISHS allowed us to obtain very good clinical results with no complications or recurrences with a minimum 2 years follow up.
Arthroscopic treatment of trochanteric bursitis
Authors: Magi Gonzalo J. , Carucci Juan Pablo , Bergués Sebastián 
Published: December 2018

Introduction: Trochanteric bursitis (TB) is one of the most frequent causes of hip pain. Medical treatment heals 98% of the patients. Recalcitrant cases require surgical resection. There is little evidence about the gold standard of this condition. Objective: Describe clinical results, complicactions and recurrence rate of arthroscopic treatment of TB. Methods: We included all patients who failed conservative treatment and were treated with arthroscopy for TB between March 2012 and March 2018. Patients with less than 2 years of follow up and previous surgery on the hip were excluded. We performed Ilizariturri´s technique with endoscopic resection in peritrochanteric compartment. We registered modified Harris hip score (MHHS), Hip outcome score activity of daily living (EHOSDL), patients satisfaction, recurrence rate and complications. Results: Ten patients were included. Average follow up was 40 months (range 28-60 months). MMHS improved from a preoperative average score of 70 (range 62-72) to postoperative average of 90 (range 82 to 97). Average EHOSDL improvement was 29% (from 50% preoperative to 80% postoperative). All patients had excellent results. Average patient satisfaction was 7 (range 6-9). We had no recurrence or complications. Conclusion: Arthroscopic treatment of TB allowed us to obtain very good clinical results with no complications or recurrences with a minimum 2 years follow up.
Simultaneous Reconstruction of Anterior Cruciate Ligament with Autologous Tendon Grafts and Medial Collateral Ligament with Allograft
Authors: Nardin Lisandro , Savá Matías , Calvet Oscar , Mercier Fernando , Barck Abel , Aparicio José Luis 
Published: December 2018

Objectives: Our objective is to show our surgical technique and experience in the combined reconstruction of ACL with autograft (either BTB or STGT) and MCL with allograft. (Aquiles Tendon) Methods: Twenty eight (28) patients, with an average age of 29,5, to whom an ACL and an MCL reconstruction with auto graft and allogeneic graft respectively was performed. These patients experienced residual internal instability after conservative treatment. Average follow-up was 19.6 months. Range of motion, joint laxity and subjective functionality were evaluated whit Lysholm scores and International Knee Documentation Committee (IKDC). Results: The Average Lysholm knee score was 93, while all the patients were classified A/B according to the IKDC and were able to return to their normal sport and daily activity. Conclusion: Nowadays various reconstructive techniques of anterior cruciate ligament (ACL) and of medial collateral ligament (MCL) are being utilized. Over the years the use of allografts have become common due to their safety, accesibility and satisfactory functional results. In multi-ligament injuries the single use of allografts or in combination with autologous grafts have become a valid resource. The lower risk of morbidity from the donor zone, the lower exposure of tissues, the lower postoperative pain with the MCL allogeneic graft at a low cost and greater security with ACL autologous graft have turned this surgical technique in a viable option for multi-ligament injured knee reconstruction.
Simultaneous Double-boundle “All Inside” Posterior Cruciate Ligament and Anterior Cruciate Ligament Reconstruction: 2 Years Follow Up
Authors: Farina Franco , Orlando Matías , Weisburd Ma. Florencia , Vega Francisco , Morales Emilio , Vedova Franco Della , Galán Hernán 
Published: December 2018

The purpose of this study was to evaluate the clinical results of simultaneuos Double-boundle “All Inside” posterior Cruciate Ligament (PCL) and Anterior Cruciate Ligament (ACL) Reconstruction. Methods: this study population included 31 men and 2 women with 26 acute and 7 chronic knee injuries. Ligament injuries included 21 ACL / PCL / Posterolateral instability, 9 ACL / PCL / Medial Cruciate Ligament (MCL), 3 ACL / PCL instability. Artroscopically assited combined ACL/PCL. Reconstruction were performed using the All Inside PCL reconstruction and ACL anatomical Reconstruction. The patients were followed up for a minimum of 2 years and evaluated according to the International Knee Documentation Committee (IKDC) and Lysholm Rating scale. The anterior-posterior knee laxity was assessed by KT-1000 examination. Results: At the last Follow Up, all patients showed normal knee extension. Two patients had 10 grades flexion limitation, and five had a 5 grades flexion limitation. The Lysholm scores was 90,4 +/- 4,6. According to the last IKDC evaluation, the results were graded as normal in 21 patients (63,6%), nearly normal in 11 patients (33,3%), and abnormal in 1 patient (3,1%). The KT-1000 examination showed that de side to side difference in overall anterior-posterior laxity at 70 grades flexion was 0 to 2 mm in 24 patients, 3 to 5 mm in 8 patients, and 6 to 10 mm in 1 patient; the side to side difference in overall anterior-posterior laxity at 20 grades flexion was 0 to 2 mm in 23 patients, 3 to 5 mm in 9 patients and 6 to 10 mm in 1 patient. Conclusion: simultaneuos Double-Boundle “All Inside” PCL and ACL reconstruction can effectively and safely restore knee stability, and can yield normal results in 62,5% of patients and nearly normal in 33,3% at minimum 2 years.