bluuebunny/crossref_metadata_2025_split huggingface dataset:
Is four-week underwater treadmill exercise regimen compared to home exercise efficacious for pain relief and functional improvement in obese patients with knee osteoarthritis? A randomized controlled trial
Authors: Kuptniratsaikul Vilai , Kittichaikarn Chawalit , Suntornpiyapan Phitsanu , Kovintaset Kriangkrai , Inthibal Suwicha 
Published: August 2018

Objective: To investigate the efficacy of a four-week underwater treadmill exercise regimen compared to a home exercise regimen relative to pain relief and functional improvement in obese patients with knee osteoarthritis. Design: Single-blind randomized controlled trial. Setting: Outpatient. Participants: Eighty primary knee osteoarthritis with pain ⩾5/10 and body mass index ⩾25 kg/m2. Interventions: Daily quadriceps exercise at home for 30 minutes (control group) or underwater treadmill exercise (study group) for 30 minutes/day, three times/week for four weeks. Main outcomes: Pain score, six-minute walking distance, quadriceps strength, and body weight were evaluated at baseline and after four weeks. Adverse events, global assessment, and satisfaction index were assessed at the end of study. Results: All outcomes in both groups were significantly improved at the end of the study, except for body weight. The mean difference (95% confidence interval (CI)) in outcomes between groups were −0.53 (−1.31, 0.26) for pain; 10.81 (−11.9, 33.53) meters for 6-minute walking distance; 0.67 (−0.10, 1.44) kilograms for quadriceps strength; and 0.01 (−0.66, 0.68) kilograms for body weight. No significant differences were observed between groups, for the per protocol analysis or the intention-to-treat analysis. Participants in the study group evaluated significantly better global improvement and higher patient satisfaction than those in control group (13 (39.4%) vs. 4 (10.8%); P = 0.014 and 23 (69.7%) vs. 16 (43.2%); P = 0.021, respectively). Conclusion: Exercise using an underwater treadmill was found to be as efficacious as home exercise for relieving pain and improving function in obese people with mild to moderate knee osteoarthritis.
Performance comparison in Pediatric Fundamental Critical Care Support among staff from the USA versus those from resource-limited countries
Authors: Pierre Louisdon , Adeyinka Adebayo , Kioko Marilyn , Hernandez Rivera Jose F. , Pinto Rohit 
Published: August 2018

Objective This study aimed to evaluate the performance of participants in the USA compared with international participants taking the Pediatric Fundamental Critical Care Support (PFCCS) course, and the significance of training for resource-limited environments. Methods PFCCS courses were conducted in the USA, El Salvador, Haiti, Kenya, and Nepal between January 2011 and July 2013. All of the participants took pre- and post-tests. We compared the performance of these tests between international and USA participants. All participants answered a post-course survey to evaluate the didactic lectures and skill stations. Results A total of 244 participants took the PFCCS course, comprising 71 from the USA, 68 from Kenya, 37 from Haiti, 48 from Nepal, and 20 from El Salvador. The mean pre-test score of USA participants (50.6%) was significantly higher than that of international participants (44.7%). There was no significant difference in the post-test score between USA and international participants (78.6% versus 81.4%). There was a significant difference between pre- and post-test scores. There was better appreciation of the course content by the USA participants. Conclusion International course takers without prior pediatric intensive care training have similar test scores to USA participants suggesting comparable efficacy.
Hypocalcemia-based prediction of hungry bone syndrome after parathyroidectomy in hemodialysis patients with refractory secondary hyperparathyroidism
Authors: Yang Guang , Zha Xiaoming , Mao Huijuan , Yu Xiangbao , Wang Ningning , Xing Changying 
Published: August 2018

Objective This study was performed to explore the risk factors for hungry bone syndrome (HBS) and establish prediction equations for calcium supplementation after parathyroidectomy in hemodialysis patients with secondary hyperparathyroidism. Methods We retrospectively analyzed data from 252 hemodialysis patients undergoing successful total parathyroidectomy with autotransplantation. HBS was defined according to a minimum postoperative serum corrected calcium (PcCa) concentration of <2.0 mmol/L. Independent predictors of HBS were analyzed, and prediction equations for HBS were derived accordingly. Results The incidence of HBS was 71.4%. The serum corrected calcium and preoperative serum alkaline phosphatase (ALP) concentrations were independent predictors of HBS. The preoperative serum ALP, intact parathyroid hormone (iPTH), and hemoglobin concentrations were independent factors influencing the average descending velocity of the PcCa concentration before calcium supplementation (PcCa-V), intravenous calcium supplement holding time (IVCa-T), and intravenous calcium supplement dosage (IVCa), while the serum ALP and iPTH concentrations were independent predictors of the oral calcium supplement dosage (OCa). Four prediction equations for PcCa-V, IVCa-T, IVCa, and OCa were established. Conclusions Establishment of prediction equations for HBS may contribute to a new individualized therapy for patients with HBS.
Early Outcomes and Perioperative Complications of the Arthroscopic Latarjet Procedure: Systematic Review and Meta-analysis
Authors: Cerciello Simone , Corona Katia , Morris Brent Joseph , Santagada Domenico Alessandro , Maccauro Giulio 
Published: August 2018

Background: The arthroscopic Latarjet-Bristow procedure is emerging as a reliable alternative to the open procedure. The reduced soft tissue damage with potential advantages of early pain control and functional recovery is attractive. However, the operation is technically more demanding, and there are concerns regarding the potential for increased recurrence and complication rates. Purpose: To evaluate the available literature focusing on the reported functional outcomes and complications of the arthroscopic Latarjet procedure and compare them with the open procedure. Study Design: Systematic review and meta-analysis. Methods: A comprehensive systematic review was performed with the keywords “arthroscopy,” “arthroscopic,” “Latarjet,” and “Bristow,” with no limit regarding the year of publication. The review was limited to the English-language articles, and each article was evaluated with a modified MINORS (methodological index for nonrandomized studies) scoring system. Results: Fourteen studies met the inclusion criteria and were included in the review. Overall, 813 patients met inclusion criteria, with a mean follow-up of 24.5 months. The mean Walch-Duplay and Rowe scores were 89.6 and 90.2, respectively. The overall complication rate was 16.5%; intraoperative conversion to open surgery, 2%; recurrence, 2.5%; and revision surgery, 5.6%. When only comparative studies were considered, the overall complication rates were 23.7% (arthroscopically) and 15.3% (open). The recurrence and revision surgery rates were 6.5% and 5.7% in the study group, while the corresponding values in the control group were 4% and 2.9%. The mean MINORS score was 14.5 (11.6 for noncomparative studies and 19 for comparative studies). Conclusion: The arthroscopic Latarjet-Bristow procedure is reliable. Outcomes are satisfactory, with less pain and faster recovery in the first postoperative week. However, the procedure is technically demanding, and higher rates of complications and reoperations should be expected. Finally, the arthroscopic operation is much more expensive in terms of implanted materials than the open procedure.
Increased Postoperative Manual Knee Laxity at 2 Years Results in Inferior Long-term Subjective Outcome After Anterior Cruciate Ligament Reconstruction
Authors: Sundemo David , Sernert Ninni , Kartus Jüri , Hamrin Senorski Eric , Svantesson Eleonor , Karlsson Jón , Samuelsson Kristian 
Published: August 2018

Background:Increased postoperative rotatory knee laxity after anterior cruciate ligament (ACL) reconstruction may be associated with an increased risk of osteoarthritis and inferior subjective outcome, although long-term studies are lacking. In terms of anteroposterior knee laxity, this association has not yet been established.Purpose/Hypothesis:The purpose was to investigate whether postoperative knee laxity is associated with inferior long-term outcome in patients who have undergone ACL reconstruction. The hypothesis was that increased laxity would cause an inferior long-term clinical and radiographic outcome.Study Design:Cohort study; Level of evidence, 3.Methods:A total of 193 patients underwent ACL reconstruction and were examined at both 2 and 16 years postoperatively. At the 2-year follow-up, knee laxity was tested by use of the Lachman test, the anterior drawer test, the pivot-shift test, and the KT-1000 arthrometer. Outcome variables examined at the 16-year follow-up involved a radiographic assessment of osteoarthritis, patient-reported outcome measurements, and the single-legged hop test.Results:At the long-term follow-up, 147 (76%) patients were examined. The mean follow-up period for the included patients was 16.4 ± 1.2 years. A negative Lachman test at 2 years resulted in a superior International Knee Documentation Committee (IKDC) score (76.3 ± 19.4 vs 67.8 ± 19.3, P < .05) and Lysholm score (85.2 ± 11.9 vs 76.9 ± 17.8, P < .05) at the 16-year follow-up. Correspondingly, a negative anterior drawer test at 2 years was associated with a superior IKDC score (75.3 ± 18.7 vs 62.9 ± 20.2, P < .05) and Lysholm score (84.1 ± 12.1 vs 72.6 ± 20.2, P < .05) at 16 years. A negative pivot-shift test resulted in a superior IKDC score (74.5 ± 18.8 vs 46.9 ± 17.8, P < .05), a superior Lysholm score (83.3 ± 13.4 vs 58.9 ± 23.0, P < .05), and an increased level of activity (Tegner activity scale, median [range]: 4 [1-10] vs 3 [0-5], P < .05). Osteoarthritis was overrepresented in patients with positive manual knee laxity tests, but the difference was not statistically significant. The KT-1000 arthrometer result was not correlated with any outcome variables assessed in this study.Conclusion:Increased manual anteroposterior and rotatory knee laxity 2 years after ACL reconstruction is associated with an inferior long-term subjective outcome.
Case Report: Targeting for Deep Brain Stimulation Surgery Using Chronic Recording and Stimulation in an Inpatient Neuromodulation Monitoring Unit, With Implantation of Electrodes in GPi and Vim in a 7-Year-Old Child With Progressive Generalized Dystonia
Authors: Sanger Terence D. , Robison Aaron , Arguelles Enrique , Ferman Diana , Liker Mark 
Published: August 2018

Background: Deep brain stimulation for secondary dystonia has been limited by unknown optimal targets for individual children. Objectives: We report the first case of a 7-year-old girl with severe generalized dystonia due to acquired striatal necrosis in whom we used a new method for identifying targets for deep brain stimulation. Methods: We implanted temporary depth electrodes in 5 different nuclei bilaterally in the basal ganglia and thalamus, with test stimulation and recording during 1 week while the child was an inpatient in a neuromodulation monitoring unit. Results: Single-unit activity in ventral intermedius Vim, internal globus pallidus (GPi), and subthalamic (STN) nuclei occurred during dystonic spasms and correlated with electromyography. Stimulation in Vim eliminated dystonic spasms. Subsequent implantation of 4 permanent deep brain stimulation electrodes in bilateral Vim and Gpi nuclei resolved dystonic spasms. Conclusion: The use of temporary stimulation and recording electrodes to identify deep brain stimulation targets is a promising new technique that could improve outcomes in children with acquired dystonia.
Evaluation of Long-term Outcomes Following Plantar Fasciotomy
Authors: Gibbons Rebekah , Mackie Katherine E. , Beveridge Todd , Hince Dana , Ammon Peter 
Published: August 2018

Background: Plantar fasciitis is a common condition prevalent in both athletic and nonathletic populations. Approximately 10% of patients do not respond to conservative treatment and suffer chronic recalcitrant plantar fasciitis. Outcomes following plantar fasciotomy vary but short-term studies have reported excellent early pain relief and return to activity, and significant improvements in symptoms. Previous study limitations include small patient cohorts, short-term duration of follow-up or lack of validated outcome measures. We therefore aimed to investigate the long-term outcomes following complete plantar fasciotomy. Methods: Patients who underwent complete plantar fasciotomy surgery from a single surgeon within the past 10 years (minimum 7 months) were invited to participate in this retrospective survey study. To evaluate patient-reported function, participants were asked to complete the Foot and Ankle Outcome Score (FAOS). To assess subjective outcome, the participants were provided a satisfaction survey. The satisfaction survey was designed to include the 3 key factors for assessing postoperative patient satisfaction, which are preoperative expectations, symptom relief, and hospital experience. A total of 74 questionnaires were returned. Results: The median global satisfaction score was 85.4 (IQR=37.5) points out of 100. Significant correlations between the global patient satisfaction score and all FAOS subscale scores were identified. Only 3 participants (4%) reported a complication following surgery; however, 32 participants (44.4%) indicated that they still experienced swelling and/or tenderness in their foot at the time of the survey (mean follow-up time 4.8 ± 2.8 years) but for the majority of patients this was improved from before surgery. Conclusion: Long-term patient satisfaction was experienced by the majority of patients following plantar fasciotomy. Although 44% of patients continue to have postoperative complaints, 73% indicated that they were satisfied with their symptoms postoperatively, and 74% would undergo a similar procedure again. Level of Evidence: Level IV, case series.
Deep Tissue Sequencing Using Hypodermoscopy and Augmented Intelligence to Analyze Atypical Pigmented Lesions
Authors: Khodadad Iman , Shafiee Javad , Wong Alexander , Kazemzadeh Farnoud , Arlette John 
Published: August 2018

Background: Over the past decade, new technologies, devices, and methods have been developed to assist in the diagnosis of cutaneous melanocytic lesions. Objective: Our objective was to evaluate the performance of an augmented intelligence system in the assessment of atypical pigmented lesions. Methods: Nine atypical pigmented lesions on 8 patients were evaluated prior to surgical removal. No lesions had received previous treatment other than a diagnostic biopsy. Prior to surgical removal, each lesion was evaluated by an Augmented Intelligence Dermal Imager (AID) and the assessment parameters reviewed in light of the final histopathological diagnosis. Results: The AID was used to evaluate a limited set of atypical pigmented lesions and showed sensitivity and specificity of 82% and 61%, respectively, based on its internal risk assessment algorithms. Limitations: These cases represent early assessments of the AID in a clinical setting, all prior assessments having been carried out on digital images. The information received from these evaluations requires further validation and analysis to be able to extrapolate its clinical usefulness. Conclusion: The AID combines dermoscopy, hypodermoscopy, and a trained augmented algorithm to produce a diffusion map representing the features of each lesion compared to the learned characteristics from a database of known dermoscopy images of lesions with definitive prior diagnosis. The information gathered from the diffusion map might be used to calculate a malignancy risk factor for the lesion compared to known melanoma features. This malignancy risk factor could be helpful in providing information to justify the biopsy of an atypical pigmented lesion.
An mHealth intervention to improve nurses’ atrial fibrillation and anticoagulation knowledge and practice: the EVICOAG study
Authors: Ferguson Caleb , Hickman Louise D , Phillips Jane , Newton Phillip J , Inglis Sally C , Lam Lawrence , Bajorek Beata V 
Published: August 2018

Background: There is a need to improve cardiovascular nurses’ knowledge and practices related to stroke prevention, atrial fibrillation and anticoagulation therapy. Aims: The aim of this study was to evaluate the efficacy of EVICOAG – a novel mHealth, smartphone-based, spaced-learning intervention on nurses’ knowledge of atrial fibrillation and anticoagulation. Methods: Nurses employed in four clinical specialties (neuroscience, stroke, rehabilitation, cardiology) across three hospitals were invited to participate. In this quasi-experimental study, 12 case-based atrial fibrillation and anticoagulation learning scenarios (hosted by an mHealth platform) were delivered to participants’ smartphones over a 6-week period (July–December 2016) using a spaced timing algorithm. Electronic surveys to assess awareness and knowledge were administered pre (T1) and post (T2) intervention. Results: From 74 participants recruited to T1, 40 completed T2. There was a 54% mean improvement in knowledge levels post-intervention. The largest improvement was achieved in domains related to medication interaction and stroke and bleeding risk assessment. Post-intervention, those who completed T2 were significantly more likely to use CHA2DS2-VASc (2.5% vs. 37.5%) and HAS-BLED (2.5% vs. 35%) tools to assess stroke and bleeding risk, respectively ( P<0.01). Conclusion: The EVICOAG intervention improved nurses’ knowledge of atrial fibrillation and anticoagulation, and influenced their uptake and use of stroke and bleeding risk assessment tools in clinical practice. Future research should focus on whether a similar intervention might improve patient-centred outcomes such as patients’ knowledge of their condition and therapies, medication adherence, time in the therapeutic range and quality of life.
What constitutes the ‘Minimal Care’ interventions of the nurse, physiotherapist, dietician and psychologist in Cardiovascular Rehabilitation and secondary prevention: A position paper from the Italian Association for Cardiovascular Prevention, Rehabilitation and Epidemiology
Authors: Fattirolli Francesco , Bettinardi Ornella , Angelino Elisabetta , da Vico Letizia , Ferrari Marina , Pierobon Antonia , Temporelli Daniele , Agostini Susanna , Ambrosetti Marco , Biffi Barbara , Borghi Silvana , Brazzo Silvia , Faggiano Pompilio , Iannucci Manuela , Maffezzoni Barbara , Masini Maria Luisa , Mazza Antonio , Pedretti Roberto , Sommaruga Marinella , Barro Sabrina , Griffo Raffaele , Piepoli Massimo 
Published: August 2018

Background In cardiovascular prevention and rehabilitation, care activities are carried out by different professionals in coordination, each with their own specific competence. This GICR–IACPR position paper has analysed the interventions performed by the nurse, physiotherapist, dietician and psychologist in order to identify what constitutes minimal care, and it lists the activities that are fundamental and indispensable for each team member to perform in clinical practice. Results In analysing each type of intervention, the following dimensions were considered: the level of clinical care complexity, determined both by the disease and by environmental factors; the ‘area’ complexity, i.e. the specific level of competence required of the professional in each professional section; organisational factors, i.e. whether the care is performed in an inpatient or outpatient setting; duration of the rehabilitation intervention. The specific contents of minimal care have been identified for each professional area together with the specific goals, the assessment tools and the main essential interventions. For the assessments, only a few validated tools have been indicated, leaving the choice of which instrument to use to the individual professional based on experience and usual practice. Conclusion For the interventions, attention has been focused on conditions of major complexity requiring special care, taking into account the different care settings, the clinical conditions secondary to the disease event, and the distinct tasks of each area according to the operator's specific role. The final report performed by each professional has also been included.
Protective effect of physical activity on mortality in older adults with advanced chronic heart failure: A prospective observational study
Authors: Cacciatore Francesco , Amarelli Cristiano , Ferrara Nicola , Della Valle Elisabetta , Curcio Francesco , Liguori Ilaria , Bosco Quirino , Maiello Ciro , Napoli Claudio , Bonaduce Domenico , Abete Pasquale 
Published: August 2018

Objectives The objective of this study was to evaluate the effect on mortality of self-reported physical activity evaluated by the physical activity scale for the elderly (PASE) in elderly patients with advanced heart failure enrolled in a cardiac rehabilitation unit after heart failure decompensation (NYHA class IIIB). Methods The study prospectively enrolled 314 elderly patients (≥65 years) with heart failure in NYHA class IIIB (symptomatic with a recent history of dyspnoea at rest) consecutively admitted to cardiac rehabilitation between January 2010 and July 2011. Comprehensive geriatric assessment was performed. Physical activity was evaluated by PASE and stratified in tertiles (0–15, 16–75 and >75). Mortality was collected from September to October 2015 in 300 patients. Results The mean age was 74.5 ± 6.1 (range 65–89); 74.7% were men, 132 patients (44.0%) died during the follow-up (44.1 ± 20.7 months). Univariate analysis shows that physical activity level conducted before heart failure decompensation was inversely related to mortality (from 76.0% to 8.2%, P = 0.000). Multivariate analysis confirms that the PASE score predicts mortality independently of several demographic and clinical variables (hazard rate 0.987, 95% confidence interval (CI) 0.980–0.994, P = 0.000). Notably, when considering PASE 0–15 versus 16–75 score and PASE 0–15 versus > 75 score, the hazard rate is 4.06 (95% CI 1.67–9.84, P < 0.001) and 7.25 (95% CI 2.7–19.5, P < 0.001), respectively. Conclusions Physical activity level evaluated by the PASE score is inversely related to mortality in elderly patients with advanced heart failure confirming the reduction of mortality exerted by moderate physical activity in such patients.