bluuebunny/crossref_metadata_2025_split huggingface dataset:
Changes of hindfoot alignment after high or low tibial osteotomy
Authors: Choi Jun Young , Suh Jin Soo , Lee Dong Joo 
Published: September 2018

Category: Hindfoot Introduction/Purpose: We aimed to determine the change in hindfoot alignment after high (HTO) or low tibial osteotomy (LTO), which is commonly performed to prevent the progression of arthritis of the knee or ankle. Methods: We retrospectively reviewed the radiographic findings of patients who underwent HTO or LTO for arthritis with varus deformity of the knee or ankle joint. The hindfoot alignment view angle (HAVA), hindfoot alignment ratio (HAR), and hindfoot moment arm (HMA) were measured using the hindfoot alignment radiographs. All radiographic parameters were measured at 3, 6, and 12 months postoperatively to assess serial changes. Results: In the HTO group, the HAVA and HMA were significantly increased at 12 months postoperatively compared to preoperatively (P=0.03 and 0.001, respectively). Similarly, the HAR increased from 0.23 preoperatively to 0.44 at 12 months postoperatively, which was a statistically significant change (P=0.001). In the LTO group, the 12-month postoperative HAVA, HAR, and HMA were significantly decreased (P=0.001 for each), which represented a hindfoot alignment change to the valgus position. Conclusion: After HTO, preoperative hindfoot valgus deviation was significantly decreased at 12 months and approached normal values, while the preoperative mild hindfoot varus alignment was changed to valgus deviation after LTO.
Incidence, Risk Factors, and Treatment of Achilles Tendon Rupture in Patients with End-Stage Renal Disease
Authors: Humbyrd Casey , Bae Sunjae , Segev Dorry 
Published: September 2018

Category: Trauma Introduction/Purpose: Patients who are dialysis-dependent and those who have received kidney transplants may be at increased risk for Achilles tendon rupture (ATR) as a result of compromised kidney function. Our goal was to examine the incidence, risk factors, and type of ATR treatment in patients with end-stage renal disease (ESRD). Methods: We studied all Medicare patients with ESRD from 1999 through 2013, as captured by the Centers for Medicare & Medicaid Services and the United States Renal Data System. Patients were categorized as not waitlisted for a transplant, waitlisted but not yet transplanted, or received a transplant. Patients were migrated to the corresponding groups at the time when they were waitlisted or received a transplant. We performed multivariate negative binomial regression using age, race, sex, body mass index, cause of ESRD, comorbidities, and year of study entry as covariables to estimate the adjusted incidence rate ratios (aIRR) for all groups and to identify risk factors for ATR. We performed a subgroup analysis using the above methods for participants with Medicare Part D to characterize the association of fluoroquinolones and steroids with ATR. Results: We identified 1091 ATRs (incidence, 3.80 per 10,000 person-years; 95% confidence interval [CI], 3.58–4.03). Patients who sustained an ATR were significantly younger, had higher mean body mass index, and had fewer comorbidities than patients without ATR. Compared with the incidence of ATR among transplant recipients, the incidence of ATR was lower in the non-waitlisted group (aIRR, 0.44; 95% CI, 0.37–0.53) and similar in the waitlisted group (aIRR, 0.94; 95% CI, 0.78–1.12). Patients who used fluoroquinolones and steroids had a higher incidence of ATR (aIRR 1.65; 95% CI, 1.32 -1.84 and aIRR 1.72, 95% CI, 1.44-2.05 respectively). A small proportion of patients (n = 184; 17%) received surgical treatment within 14 days of diagnosis of ATR, and the 30-day cumulative incidence of surgical site infections was 6.5%. Conclusion: The incidence of ATR was higher in the transplanted and waitlisted groups compared with the non-waitlisted group. Younger age, higher body mass index, better health, fluoroquinolone use and steroid use were significant risk factors for ATR. Patients were more likely to receive nonoperative than surgical treatment for ATR. Those who underwent surgical treatment for ATR had a low incidence of surgical site infection.
Use of the Extended Sinus Tarsi Approach for Treatment of Displaced Intra-articular Calcaneal Fractures Compared with the Extended Lateral Approach
Authors: Kang Chan , Kim Dong Yeol , Song Jae-Hwang , Lee Jeong-kil , Song Seokhwan , Hwang Sungjin , Lee Gi-Soo , Choi Bo Sung , Seo Gangwon , Kim Yonghyun 
Published: September 2018

Category: Trauma Introduction/Purpose: We compared the radiographic results and clinical outcomes of patients with displaced, intra-articular calcaneal fractures treated via the extended sinus tarsi approach (ESTA) and the extended lateral approach (ELA). Methods: We retrospectively studied the utility of the ELA (46 patients, 52 feet) and the ESTA (56 patients, 64 feet) in patients operated upon between January 2009 and September 2014. We evaluated pre- and post-operative X-rays and computed tomography (CT) data. Pain, patient-reported functional outcomes, patient satisfaction, and postoperative complications, were investigated at the three year follow-up. Results: Neither the postoperative nor three year follow-up Böhler angles, nor the calcaneal width, differed significantly between the two groups (both p > 0.05). The maximum step-off of the posterior facet on the three month CT follow-up of the ESTA was significantly less than that of the ELA (p < 0.05). We found no significant between-group differences in terms of postoperative translation (p = 0.232) or angulation of the sustentacular fragment (p = 0.132), three year follow-up mean visual analog scale pain score at rest (p = 0.641) or during weight-bearing (p = 0.525), Foot Function Index (FFI) (p = 0.712), and self-reported satisfaction (p = 0.823). The ELA experienced significantly more wound complications (p = 0.039) and nonunions (p = 0.014) than the ESTA. Conclusion: Compared with the ELA, the ESTA afforded comparable radiological results and clinical outcomes, associated with a reduced operative time and fewer wound complications and nonunions. We suggest that the ESTA is an efficient surgical option when treating displaced, intra-articular calcaneal fractures.
Radiographic Analysis of Surgically Treated Flatfoot Deformity in Children with Cerebral Palsy
Authors: Kerrigan Alicia , Kishta Waleed 
Published: September 2018

Category: Midfoot/Forefoot Introduction/Purpose: Pes planovalgus is the most common foot deformity in children with cerebral palsy (CP). Many of these patients become functionally limited and require surgical intervention. The objectives of this study are to apply previously validated radiographic parameters to radiographs of children with CP who have undergone surgical intervention for pes planovalgus deformity and to assess if these radiographic parameters show improvements post-operatively. Furthermore, this study aims to determine which of these parameters can most accurately be used to quantify correction post-surgery. Methods: A retrospective review was performed to identify patients aged five to 17 with a diagnosis of CP who underwent lateral calcaneal lengthening osteotomy for pes planovalgus between 2006 and 2015 at London Health Sciences Center. The previously validated radiographic measurements were applied to pre-operative and post-operative radiographs. A normality test was performed to observe whether participants were normally distributed with regard to the severity of their deformity. Paired T-test and Wilcoxon signed-rank test were used to compare changes in radiographic measurements from before and after surgery. Results: Seventeen patients met the inclusion criteria. The average age of selected patients was 13.06 years (range 9.42-16.75 years). This included 11 males and six females, all with spastic CP (12 diplegic, five hemiplegic). Of these patients, 11 underwent bilateral surgery and six underwent unilateral surgery (28 feet). These patients were followed post-operatively for a mean of 7.97 months (range 1.5-20 months). In comparing the radiographs from before and after surgery, statistically significant changes were seen in five out of the seven measurements. Talonavicular coverage angle was found to have the most significant change post-correction. Conclusion: The previously validated radiographic parameters used to assess foot and ankle deformity can be applied to the surgically treated pes planovalgus foot in patients with CP. It was found that five out of the seven measurements used to assess foot deformity changed significantly with surgical intervention. Talonavicular coverage angle was found to be the most accurate measure for post-surgical correction. This is the first study to apply these parameters to CP patients with surgically treated flatfoot deformity. Lateral calcaneal lengthening osteotomy significantly improves these radiographic measures.
Prognostic Risk Factors for Complications Associated with Below the Knee Amputations
Authors: Ni Jason , Lukosius Eric , Saloky Kaitlin , Walley Kempland , Ludwick Leanne , Stauch Chris , Juliano Paul , Aydogan Umur , Aynardi Michael 
Published: September 2018

Category: Other Introduction/Purpose: Below the knee amputation (BKA) is an effective surgical procedure for individuals with severe injury or infection to their lower extremities. However, patients who receive these procedures are subject to significant morbidity and a high rate of postoperative complications due to the presence of multiple concomitant comorbidities. Despite the wide practice of this intervention, prognostic risk factors aiding in predicting surgical outcomes in these patients are poorly understood. The purpose of this study is to evaluate risk factors that may contribute to the outcomes of BKA procedures. Methods: The clinical and radiographic outcomes for 89 patients ages 19-90 who underwent BKA were retrospectively evaluated from 2012-2017. Postoperative complications of mortality, infection, and reoperation were evaluated with patient and surgical variables. Patient variables included: age, ambulatory status, obesity, diabetes, HbA1C2 levels, neuropathy, smoking, Charlson Comorbidity Index (CCI), and American Society of Anesthesiologists (ASA) classification. Surgical variables evaluated included: presence of pre-op infection, pre-op ambulatory status, tourniquet time, tourniquet pressure, and usage of prophylactic antibiotics. Results: Of the patients evaluated there was an overall complication rate of 49% (44/89) and a mortality rate of 19% (17/89). Patients with diabetes (p=.035), a greater score on the Charlson Comorbidity Index (p=.001), and an ASA classification =3 (p=.005) were associated with a greater risk of mortality. Operative values (i.e. tourniquet time, tourniquet pressure etc.) did not affect patient mortality rates in a significant way, but there was a higher incidence of complications (i.e. mortality, post-op infections, and reoperations) with patients with pre-operative infections. Conclusion: Diabetes, a higher CCI score and a greater ASA value were found to be significant predictors of patient mortality after BKA (p<0.05). Future perioperative optimization in these patients identified as high risk may improve patient outcomes in the future.
Short-term Complications, Reoperations, and Radiographic Outcomes of the Infinity Total Ankle Arthroplasty
Authors: Saito Guilherme , Sanders Austin , de Cesar Netto Cesar , O’Malley Martin , Ellis Scott , Demetracopoulos Constantine 
Published: September 2018

Category: Ankle Arthritis Introduction/Purpose: With the increasing use of total ankle arthroplasty (TAA), new implants with varied configurations are being developed every year. This study aims to provide the early complications, reoperations and radiographic and clinical outcomes of the Infinity TAA. To date, clinical results of this novel fixed-bearing implant have not been published. Methods: A retrospective analysis of 64 consecutive ankles that underwent a primary Infinity TAA from July 2014 to April 2016 was performed. Patients had an average follow-up of 24.5 (range, 18-39) months. Medical records were reviewed to determine the incidence of complications, reoperations and revisions. Radiographic outcomes included preoperative and postoperative tibiotalar alignment, tibial implant positioning, the presence of periprosthetic radiolucency and cysts, and evidence of subsidence or loosening. Additionally, patient-reported outcomes were analyzed with the Foot and Ankle Outcome Score (FAOS) preoperatively and 1-year postoperatively. Results: Survivorship of the implant was 95.3%. Fourteen ankles (21.8%) presented a total of 17 complications (Table 1). A total of 12 reoperations were necessary in 11 ankles (17.1%). Revision surgery was indicated for 3 ankles (4.7%) due to isolated subsidence of the tibial implant in 2 cases and due to subsidence of both the tibial and talar components in 1 case. Tibiotalar coronal deformity was significantly improved after surgery (P < .0001) and maintained during latest follow-up (P = .81). Periprosthetic radiolucent lines were observed around the tibial component in 20 ankles (31%) and around the talar component in 2 ankles (3.1%). A tibial cyst was observed in 1 ankle (1.5%). Outcome scores were significantly improved for all FAOS components analyzed (P < .0001). Conclusion: Most complications observed in the study were minor and successfully treated with a single reoperation procedure or nonoperatively. Failures and radiographic abnormalities were most commonly related to the tibial implant. Further studies with longer follow-up are needed to evaluate the survivorship of the tibial implant in the long-term.
Risk factors for intra-operative and post-operative fractures associated with primary total ankle replacement surgery - a data linkage study from the UK National Joint Registry
Authors: Zaidi Razi , Goldberg Andrew 
Published: September 2018

Category: Ankle Introduction/Purpose: Intra and post-operative fractures are recognised complications of total ankle replacement (TAR) surgery. Intra-operative fractures are captured on the National Joint Registry (NJR) in the UK. The NJR has been capturing data on ankle replacement surgery since April 2010 and the number of TARs on the register is approaching 4000. Post-operative fractures are captured in the Hospital Episodes Statistics (HES) database. HES stores all patients admitted to NHS hospitals in England and captures 125 million records each year. Diagnostic information is stored using the International Classification of Diseases (ICD) and operative details using the Office of Population, Censuses and Surveys Classification (OPCS) codes. The purpose of this work was to determine the rate of intra and post-operative fracture with primary TAR and determine risk factors. Methods: A data-linkage study of the UK National Joint Registry (NJR) data and Hospital Episodes Statistics (HES) database was peformed using the first 3 years of NJR data. These two databases were linked in a deterministic fashion. 1522 NJR records were linked with the HES data set of over 90 million records. 1110 records were able to linked and available for analysis. Unlinked NJR data was analysed to identify intra-operative fractures. Linked data was analysed to identify post-operative fractures using ICD codes. Logistic regression was used to model predictors of intra and post-operative fractures. Every model was adjusted for patient characteristics including age, BMI, comorbidity and ASA grade. Results: The rate of intra-operative fracture was 2.69% (95% CI 2.67% to 2.74%). When looking at patient characteristics no significant predictors emerged. Logistic regression adjusted for patient characteristics showed that patients with rheumatoid arthritis were twice as likely to have a intra-operative fractures. The rate of post-operative fracture in the 12 months following primary TAR was 1.08% (95% CI 1.05% to 1.14%). Age emerged as a risk factor with a 5 five fold increase in risk of post-operative fracture with age 65-74 compared with those below 65. Adjusted logistic regression showed an increase risk of post-operative fracture in rheumatoid patients, hybrid operations and with those with multiple concurrent procedures. The risk of fracture was doubled with one associated procedure and tripled with two procedures. Conclusion: The rate of intra and post-operative fracture associated with primary total ankle replacement is low. However care should be taken with patients over 65 as they are at greater risk of intra operative fractures. Patients with rheumatoid arthritis are at greater risk of both, likely due to the effect of drug treatment. All efforts should be made to review medications and bone protective medication prescribed for these patents when undergoing TAR.
Platelet heterogeneity in activation-induced glycoprotein shedding: functional effects
Authors: Baaten Constance C. F. M. J. , Swieringa Frauke , Misztal Tomasz , Mastenbroek Tom G. , Feijge Marion A. H. , Bock Paul E. , Donners Marjo M. P. C. , Collins Peter W. , Li Renhao , van der Meijden Paola E. J. , Heemskerk Johan W. M. 
Published: September 2018

Abstract
The platelet receptors glycoprotein Ibα (GPIbα) and GPVI are known to be cleaved by members of a disintegrin and metalloprotease (ADAM) family (ADAM10 and ADAM17), but the mechanisms and consequences of this shedding are not well understood. Our results revealed that (1) glycoprotein shedding is confined to distinct platelet populations showing near-complete shedding, (2) the heterogeneity between (non)shed platelets is independent of agonist type but coincides with exposure of phosphatidylserine (PS), and (3) distinct pathways of shedding are induced by elevated Ca2+, low Ca2+ protein kinase C (PKC), or apoptotic activation. Furthermore, we found that receptor shedding reduces binding of von Willebrand factor, enhances binding of coagulation factors, and augments fibrin formation. In response to Ca2+-increasing agents, shedding of GPIbα was abolished by ADAM10/17 inhibition but not by blockage of calpain. Stimulation of PKC induced shedding of only GPIbα, which was annulled by kinase inhibition. The proapoptotic agent ABT-737 induced shedding, which was caspase dependent. In Scott syndrome platelets that are deficient in Ca2+-dependent PS exposure, shedding occurred normally, indicating that PS exposure is not a prerequisite for ADAM activity. In whole-blood thrombus formation, ADAM-dependent glycoprotein shedding enhanced thrombin generation and fibrin formation. Together, these findings indicate that 2 major activation pathways can evoke ADAM-mediated glycoprotein shedding in distinct platelet populations and that shedding modulates platelet function from less adhesive to more procoagulant.
Phenotype description and response to thrombopoietin receptor agonist in DIAPH1-related disorder
Authors: Westbury Sarah K. , Downes Kate , Burney Claire , Lozano Maria L. , Obaji Samya G. , Toh Cheng Hock , Sevivas Teresa , Morgan Neil V. , Erber Wendy N. , Kempster Carly , Moore Samantha F. , Thys Chantal , Papadia Sofia , Ouwehand Willem H. ,   NIHR BioResource–Rare Diseases, Laffan Michael A. , Gomez Keith , Freson Kathleen , Rivera Jose , Mumford Andrew D. 
Published: September 2018

Key Points
DIAPH1-related disorder has a bilineage hematological phenotype of macrothrombocytopenia and neutropenia associated with hearing loss. Eltrombopag increased proplatelet formation from cultured DIAPH1-related disorder megakaryocytes and improved platelet counts in vivo.
Risk factors for community-acquired Escherichia coli bacteraemia: a systematic review protocol
Authors: Aryee Anna , Härmälä Suvi , Shallcross Laura , Hayward Andrew 
Published: September 2018

Introduction: Rates of community-acquired Escherichia coli bacteraemia (ECB) have been consistently rising. As rates of antimicrobial resistance (AMR), particularly in Gram-negative bacteria, are also increasing, this is of concern both for management of individual patients and healthcare systems. There is currently little data on the risk factors for development of community-acquired ECB: this review aims to identify these risk factors in order to inform community interventions to reduce ECB as well as antibiotic prescribing policy. Methods and analysis: We will search Medline (Ovid), Embase (Ovid), Web of Science/Scopus and the Cochrane Central Register of Controlled Trials for published reports on observational and experimental primary research studies involving patients admitted to hospital with community-acquired ECB. Two reviewers will independently screen the studies for eligibility, perform data collection and assess study quality and risk of bias. Random effects meta-analyses will be performed if appropriate. Ethics and dissemination: No primary data will be collected for this study and so formal ethical approval is not required. We will publish the results of our review in relevant peer-reviewed medical journals, and will also seek to present them at relevant medical conferences. PROSPERO registration number: CRD42018104402
An analysis of psychiatric services provided to adults in 2010–2014 based on the National Health Fund data
Authors: Anczewska Marta , Biechowska Daria , Galecki Piotr , Janas-Kozik Małgorzata , Koń Beata , Skrzypkowska-Brancewicz Blanka , Śremska Anna , Urbański Filip , Więckowska Barbara , Zięba Mariusz , Kucharska Katarzyna 
Published: September 2018

Cel pracyBadanie wskaźników pozwalających na poprawę zdrowia populacji poprzez m.in. poprawę jakości udzielanych świadczeń oraz większą do nich dostępność jest jednym z priorytetów Światowej Organizacji Zdrowia (WHO). W Polsce ma to szczególnie istotne znaczenie
w okresie reformy opieki psychiatrycznej, zgodnej z wytycznymi Narodowego Programu Ochrony Zdrowia Psychicznego.
Celem prezentowanego opracowania jest analiza świadczeń psychiatrycznych udzielonych osobom dorosłym i sprawozdanych do Narodowego Funduszu Zdrowia w latach 2010-2014.MetodaW prezentowanej pracy autorzy rozszerzyli informacje zawarte w części drugiej map potrzeb zdrowotnych – oprócz oceny świadczeń udzielonych osobom dorosłym w 2014r. przedstawiono analizę świadczeń z lat 2010-2014 łącznie. Zgodnie z danymi płatnika, w latach 2010-2014 stale wzrastała zarówno liczba osób, którym udzielono świadczeń z powodu zaburzeń psychicznych, jak i łączna liczba udzielonych świadczeń. Zanotowano wzrost liczby pacjentów leczących się z powodu zaburzeń nastroju, zaburzeń nerwicowych, związanych ze stresem i pod postacią somatyczną, także uzależnień.WynikiWzrost łącznej liczby wykazanych świadczeń dotyczył głównie otwartych form leczenia: oddziałów dziennych, zespołów leczenia środowiskowego oraz ambulatoryjnej opieki psychiatrycznej. Nie można stwierdzić przyczyny ponownego wzrostu w 2014r. liczby hospitalizacji psychiatrycznych, jak również wzrostu wskaźnika liczby hospitalizacji na 100 tys. dorosłych.WnioskiUzyskane wyniki wskazują na potrzebę dalszego wspierania rozwoju opieki psychiatrycznej,
z zastosowaniem wielokierunkowości oddziaływań w zintegrowanym modelu rozwiązywania problemów zdrowotnych. Do całościowej analizy świadczeń realizowanych w opiece psychiatrycznej konieczny jest dostęp do informacji na temat świadczeń finansowanych
ze środków niepublicznych oraz poszerzenie sprawozdawanych informacji.