bluuebunny/crossref_metadata_2025_split huggingface dataset:
miR-34a and miR-9 are overexpressed and SIRT genes are downregulated in peripheral blood mononuclear cells of aging humans
Authors: Owczarz Magdalena , Budzinska Monika , Domaszewska-Szostek Anna , Borkowska Joanna , Polosak Jacek , Gewartowska Magdalena , Slusarczyk Przemyslaw , Puzianowska-Kuznicka Monika 
Published: July 2017

Increased expression of sirtuins lowers the risk of age-related diseases, while their role in the regulation of longevity is not firmly established. Since aging is associated with immunosenescence, we tested whether sirtuin expression was modified in peripheral blood mononuclear cells (PBMC) in an age-related manner and whether this might result from altered expression of the selected miRNAs. The expression of seven SIRT genes and of SIRT1 mRNA-interacting miR-9, miR-34a, miR-132, and miR-199a-5p was evaluated by real-time PCR in PBMC originating from young (Y, n = 57, mean age 27 ± 4.3 years), elderly (E, n = 52, 65 ± 3.4 years), and long-lived (L, n = 56, 94 ± 3.5 years) individuals. Older age was associated with a decreased expression of the majority of the SIRT genes. Most severely affected were median expressions of SIRT1 ( P = 0.000001 for the whole studied group, Y vs. E: P < 0.000001, Y vs. L: P < 0.000001), and of SIRT3 ( P = 0.000001, Y vs. E: P = 0.000004, Y vs. L: P = 0.000028). Older age was also associated with the increased median expression of miR-34a ( P = 0.000001, Y vs. E: P = 0.001, Y vs. L: P = 0.000004) and of miR-9 ( P = 0.05, Y vs. L: P = 0.054). In functional studies, miR-9 interacted with the 3′UTR of SIRT1 mRNA. The SIRT1 mRNA level negatively correlated with the expression of miR-34a ( r = −0.234, P = 0.003). In conclusion, age-related decrease of SIRT1 expression in PBMC might in part result from overexpression of miR-34a and miR-9. In addition, the sustained expression of the SIRT genes in PBMC is not a prerequisite to longevity in humans but might be one of the reasons for the immune system dysfunction in the elderly. Impact statement High expression of sirtuins, particularly SIRT1, lowers the risk of age-related diseases and probably slows down the rate of aging; therefore, their sustained expression should be one of the features of longevity. However, in this work we show that in peripheral blood mononuclear cells (PBMC) of long-lived individuals, expression of majority of the SIRT genes is significantly lower than in cells of young study subjects. In long-lived individuals, downregulation of SIRT1 coexists with upregulation of SIRT1 mRNA-interacting miR-34a and miR-9, indicating the role of epigenetic drift in age-dependent deregulation of SIRT1 expression. Such constellation of SIRT1, miR-34a, and miR-9 expression in PBMC of successfully aging long-lived individuals indicates that, at least in these individuals, it is not a risk factor for morbidity and mortality. It might however affect the function of the immune system and, therefore, aging individuals can profit from interventions increasing the level of SIRT1.
Conservative Management for Stable High Ankle Injuries in Professional Football Players
Authors: Knapik Derrick M. , Trem Anthony , Sheehan Joseph , Salata Michael J. , Voos James E. 
Published: July 2017

Context: High ankle “syndesmosis” injuries are common in American football players relative to the general population. At the professional level, syndesmotic sprains represent a challenging and unique injury lacking a standardized rehabilitation protocol during conservative management. Evidence Acquisition: PubMed, Biosis Preview, SPORTDiscus, PEDro, and EMBASE databases were searched using the terms syndesmotic injuries, American football, conservative management, and rehabilitation. Study Design: Clinical review. Level of Evidence: Level 3. Results: When compared with lateral ankle sprains, syndesmosis injuries result in significantly prolonged recovery times and games lost. For stable syndesmotic injuries, conservative management features a brief period of immobilization and protected weightbearing followed by progressive strengthening exercises and running, and athletes can expect to return to competition in 2 to 6 weeks. Further research investigating the efficacy of dry needling and blood flow restriction therapy is necessary to evaluate the benefit of these techniques in the rehabilitation process. Conclusion: Successful conservative management of stable syndesmotic injuries in professional American football athletes requires a thorough understanding of the anatomy, injury mechanisms, diagnosis, and rehabilitation strategies utilized in elite athletes.
The impact of drop-out in cardiac rehabilitation on outcome among coronary artery disease patients
Authors: Pardaens Sofie , Willems Anne-Marie , Clays Els , Baert Anneleen , Vanderheyden Marc , Verstreken Sofie , Du Bois Inge , Vervloet Delphine , De Sutter Johan 
Published: July 2017

Abstract

Background
The effect of adherence to cardiac rehabilitation (CR) on outcome is not clear. Therefore, we aimed to assess the impact of drop-out for non-medical reasons of CR on event-free survival in coronary artery disease (CAD).

Methods
A total of 876 patients who attended CR after acute coronary syndrome (ACS), percutaneous coronary intervention (PCI) or coronary artery bypass graft (CABG) were included. Drop-out was defined as attending ≤50% of the training sessions. A combined endpoint of all-cause mortality and rehospitalization for a cardiovascular event was used to specify event-free survival. Differences in clinical characteristics were assessed and parameters with p &lt; 0.10 were entered in a multiple Cox regression analysis.

Results
A total of 15% died or had a cardiovascular event during a median follow-up period of 33 months (interquartile range 24, 51). Overall, 17% dropped out before finishing half of the program. Patients who withdrew prematurely had a risk twice as high for a cardiovascular event or death (hazard ratio 1.92, 95% confidence interval 1.28–2.90) than those who attended more than half of the sessions. Both ACS (2.36, 1.47–3.58) and PCI (2.20, 1.22–3.96), as primary indicators for CR, were associated with an adverse outcome and also a prior history of chronic heart failure (CHF) remained negatively associated with event-free survival (3.67, 1.24–10.91). Finally, the presence of hyperlipidemia was independently related to a worse outcome (1.48, 1.02–2.16).

Conclusions
Drop-out for non-medical reasons was independently associated with a negative outcome in CAD. Therefore, underlying factors for drop-out should gain more attention in future research and should be taken into account when organizing CR.
The characterisation of unexplained pain after knee replacement
Authors: Phillips Jonathan RA , Hopwood Beverley , Stroud Rowenna , Dieppe Paul A , Toms Andrew D 
Published: July 2017

Background: The aims of this study were to characterise the pain experienced by patients with chronic pain after knee replacement (KR), in whom no apparent ‘orthopaedic’ problem could be identified, and to establish how many have pain sensitisation problems (including neuropathic pain). Methods: A total of 44 patients were prospectively evaluated at a multidisciplinary tertiary referral clinic by an orthopaedic surgeon, pain specialist, rheumatologist and physiotherapist. These patients had been pre-screened by an orthopaedic surgeon to remove cases where there was an obvious cause of pain that could be treated with revision surgery. They were then followed up to find out whether any subsequent interventions had occurred. Results: The mean time since surgery was 29 months (range: 3–108 months), and 18% were revision KR. Patients were evaluated for symptoms of nociceptive pain, allodynia, pains elsewhere and psychosocial factors. The patients were categorised into nociceptive pain 43% (n = 19), pain sensitisation 25% (n = 11) and mixed pain 32% (n = 14). Mean Visual Analogue Score (VAS) pain scores were 6.7/10 with high scores for both constant (66%) and intermittent (70%) pain elements, and pain caused high levels of interference with life. Fifty percent suffered depression and 25% suffered widespread pains (more than three pains elsewhere in the body). Patients with widespread pains suffered more pain (p = 0.01) and higher rates of both pain sensitisation (p = 0.07) and thermal allodynia (p < 0.04). Conclusion: Patients after KR can experience severe pain that interferes with their lives, depression and many have pain sensitisation problems rather than any local, nociceptive cause. We advocate screening patients with unexplained pain after KR for pain sensitisation problems, pains at other sites and depression. Appropriate further treatment and multidisciplinary interventions can then be arranged.
Biceps Tenodesis in Pitchers
Authors: Smith Chase D. , Dugas Jeffrey R. , Emblom Benton A. , Cain E. Lyle 
Published: July 2017

Objectives: SLAP tears are a common occurrence in baseball pitchers. There is not a clear consensus on the treatment of these injures in the overhead athlete, especially in the setting of a failed SLAP repair. SLAP repair in overhead athletes has had relatively poor results with return to play outcomes in several reports. Biceps tenodesis has become an option for failed SLAP repair or chronic biceps tendinitis in older patients with excellent results, but little has been reported concerning biceps tenodesis in overhead athletes. The purpose of this study was to evaluate the outcomes and function of elite level baseball pitchers after undergoing biceps tenodesis. Methods: Retrospective review was performed of 13 baseball pitchers with primary or repeat SLAP tears or biceps tendinitis who were treated with biceps tenodesis. Results: Twelve of thirteen (92%) players were contacted who underwent biceps tenodesis at mean follow-up of 3.4 years (range 1-12.3 years). Outcome measures included the ASMI labral repair outcomes questionnaire, ASES scoring system, overhead athlete shoulder and elbow score, KJOC, and the veterans rand 12 item health survey (VR-12). Eleven of 12 (92 %) contacted were able to return to playing with the most common complaint being subjective weakness and a decrease in velocity. Patients had an average score on the VR12 physical of 63, VR12 mental of 42, KJOC 79, and ASES 97. Conclusion: Biceps tenodesis in an overhead throwing athlete is an acceptable option for a failed slap repair or biceps tendonitis that fails to respond to conservative treatment. Throwing athletes should expect to get back to baseball with good outcomes, however some pain or discomfort with maximum velocity is common.
Forearm Flexor Injuries in Major League Baseball Players: Epidemiology, Performance, and Associated Injuries
Authors: Hodgins Justin Lane , Donohue Steve , Littlefield Mark , Schuk Mike , Ahmad Christopher S. 
Published: July 2017

Objectives: The flexor-pronator mass provides dynamic support to the valgus stresses in the throwing elbow and is protective to the ulnar collateral ligament (UCL). Despite evidence highlighting the importance of the forearm flexor muscles in baseball pitching, no studies have reported the epidemiology, return to play, or associated injuries in elite baseball players. The purpose of this study examine the incidence, treatment, and outcomes of forearm flexor injuries in both Major and Minor League Baseball pitchers. Methods: Injury data attributed to forearm flexor injury in Major League Baseball (MLB) and minor league teams was reviewed from 2010 to 2014. This included the numbers of players, seasonal timing of injury, days of competition missed, pre and post-injury performance data, and subsequent elbow surgery. Performance data collected consisted of ERA (earned run average), WHIP (walks plus hits per innings pitched), walks, strikeouts, and percent strikes. Results: In MLB, 134 forearm flexor injuries occurred with a mean player age of 28.6 years and 111 (82.8%) were pitchers. In the minor leagues, 629 injuries occurred with a mean age of 22.8 years where 494 (78.5%) were pitchers. The highest percentage of injuries occurred in the month of July in both MLB (17.2%) and the minor leagues (17%). The median time spent on the disabled list (DL) for MLB players was 42 days (mean 128.1) compared to 28 days (mean 105.7) in the minor leagues. Of the players in MLB who sustained a forearm injury, subsequent injuries included 50 shoulder (37.3%), 48 elbow (35.8%), and 24 forearm (17.9%) injuries. Over the study period, 26 (19.4%) MLB and 56 minor league players (8.9%) required UCL reconstruction within 365 days of sustaining a forearm injury. Performance declined in virtually all categories in the season leading to the injury when compared to the previous season (n = 75) and significant differences were present in walks plus hits per inning pitched (WHIP) (from 1.24 to 1.34, P = 0.04) and strike percentage (63% to 62%, P = 0.036). Conclusion: Flexor-pronator injuries are responsible for considerable time on the DL in elite pitchers. Injury may be preceded with declines in performance and be associated with subsequent injuries to the shoulder and elbow. [Table: see text]
Risk Factors for Reoperation and Performance-based Outcomes following Surgical Fixation of Foot Fractures in the Professional Athlete: A Cross-Sport Analysis
Authors: Singh Sameer Kumar , Larkin Kevin , Kadakia Anish R. , Hsu Wellington 
Published: July 2017

Objectives: Professional athletes are predisposed to fractures of the foot due to large stresses placed on the lower extremity; these players are concerned with efficiently returning to play at a high level. Return to play rates following operative treatment have been previously reported, yet performance outcomes following such treatment are generally unknown in this population. The purpose of this study was to assess and compare performance-based outcomes following foot fracture fixation among professional athletes of the 4 major North American sports. Methods: Athletes in the National Basketball League (NBA), National Football League (NFL), (Major League Baseball) MLB, and National Hockey League (NHL) undergoing operative fixation of a foot fracture were identified through a well-established protocol confirmed by multiple sources of the public record. Return-to-play rate and time to return were collected for each sport. League participation and game performance were collected before and after surgery. Statistical analysis was performed with significance accepted as P ≤ .05. Results: A total of 77 players undergoing 84 procedures met the inclusion criteria. Overall, 98.7% of players were able to return to play with an average time to return across all sports of 172 ± 22 days. Players returned to preoperative performance levels within one season of surgery. Six players (7.8%) sustained re-fracture requiring reoperation, all of whom were in the NBA. Percentage of games started during the season after primary surgical treatment was a predictive factor for re-injury (99% vs 40%, p = .001). Conclusion: Athletes returned to play following foot fracture fixation at a high rate with excellent postoperative performance levels, regardless of sport and fracture location. NBA athletes sustaining fifth metatarsal and navicular fractures are at a higher risk of re-injury compared to other athletes. Returning to high levels of athletic participation soon after surgery may predispose athletes to re-fracture and subsequent reoperation.
Magnetic Resonance Imaging Comparison of Repaired versus Non-Repaired Hip Capsule in Patients Undergoing Hip Arthroscopy for Femoroacetabular Impingement: A Double-Blind, Randomized Controlled Trial
Authors: Mei-Dan Omer Y. , Strickland Colin , Garabekyan Tigran , Chadayammuri Vivek , Brick Matthew , Kraeutler Matthew John 
Published: July 2017

Objectives: Techniques used in hip arthroscopy continue to evolve and controversy surrounds the need for capsule repair following surgical intervention. The purposes of this study were to evaluate the magnetic resonance imaging (MRI) appearance of the hip capsule in patients with femoroacetabular impingement (FAI) undergoing hip arthroscopy with capsular repair versus non-repair. Methods: A multicenter clinical trial was performed with 35 patients (50 hips) undergoing hip arthroscopy for treatment of FAI. Each hip was preoperatively randomized to capsular repair versus non-repair. MRI evaluation was performed by a radiologist at 6 and 24 weeks postoperatively. Patients and the radiologist were blinded to the randomization. Capsular defect size and the thickness of the capsule at the capsulotomy site and at locations both proximal and distal to the defect were recorded on each scan to determine their change over time. Results: Compared to patients without capsular repair, those with capsular repair demonstrated significantly decreased mean capsular gapping at articular and muscular portions of the hip capsule at 6 weeks postoperatively (p < 0.001). This difference normalized between the two cohorts by 24 weeks postoperatively, with a significantly decreased mean capsular gapping at articular and muscular attachment sites of the hip capsule compared to 6 weeks postoperatively (p < 0.03). Defects were readily apparent on MRI imaging in regions where the capsule was not repaired. In contrast, irregular capsular thickening without a discrete defect was visible in most cases where the capsule was repaired at the time of arthroscopy. The appearance was variable after 24 weeks. The capsular defects that did close universally showed closure of the defect beginning at the muscular side of the capsule with bridging of capsular tissue then filling in on the articular side. Conclusion: Arthroscopic hip capsule repair results in significantly less capsule gapping at 6-week follow-up compared with non-repair, though the difference in gap size normalizes by 24-week follow-up.
Meniscal Repair Outcomes in Revision ACL Reconstructions
Authors:   MARS Group
Published: July 2017

Objectives: Meniscal preservation has been demonstrated to contribute to long term knee health. This has been a successful intervention in the isolated and ACL reconstructed patient. The results of meniscus repair in the setting of revision ACL reconstruction have never been documented to any significant extent. The MARS group offers with its large cohort of revision ACL reconstructions the opportunity to explore this issue. Methods: The MARS Group was assembled with the aim of determining what impacts outcome in an ACL revision setting, and to identify potentially modifiable factors that could improve these outcomes. This collaboration consists of a group of 83 sports medicine fellowship trained surgeons across 52 IRB approved sites. Surgeons are a near equal mix of academic and private practitioners. Surgeons document surgical technique and intraarticular findings including meniscal and chondral damage and their treatment.All revision ACL reconstruction with meniscal repair cases from a multicenter group between 2006 and 2011 were selected. Two-year follow-up was obtained by both phone and email to determine whether any subsequent surgery had occurred to either knee since their initial revision ACL reconstruction. If so, operative reports were obtained, whenever possible, to verify pathologic condition and treatment. Results: 1215 patients were enrolled. 235 repairs were performed in 218 patients (19.5% of the cohort): 170 were medial, 65 lateral and 17 medial and lateral. 178 (76%) were performed with all-inside techniques. 17 repairs failed by 2 year follow up: 15 medial (8.8%; 13 all inside, 2 outside in) and 2 lateral (3.1%; both all inside). 4 of the medial failures were treated in conjunction with a subsequent repeat revision reconstruction. Conclusion: Meniscus repair in the revision setting is a successful treatment choice when appropriate. Failure rates for medial and lateral tears were both less than 10% and consistent with primary ACL reconstruction meniscus repair success rates. Medial tears underwent reoperation for failure at a statistically significant higher rate than lateral tears.
Subsequent Surgery and Prevalence of Osteoarthritis Following Arthroscopic Meniscus Posterior Root Repair: Association with Patient Age and Body Mass Index
Authors: Lamplot Joseph D. , Lillegraven Olivia , Wojahn Robert D. , Brophy Robert H. 
Published: July 2017

Objectives: Posterior meniscus root tears disrupt the tibial plateau attachment, leading to a loss of hoop stresses and significant increases in tibiofemoral contact forces. As a result, there is growing interest in surgical repair of these tears. The purpose of this study is to report rates of recurrent surgery and prevalence of osteoarthritis following posterior meniscus root repairs, and associated patient factors, in a North American population. Methods: Arthroscopic posterior meniscus root repair using a pullout trans-tibial suture method was performed by a single surgeon in the United States. Eligible patients d the Knee Injury and Osteoarthritis Outcome Score (KOOS) and reported any subsequent surgeries at minimum two-year follow-up. Patients were categorized as having clinical OA based on their KOOS score. When available, post-operative radiographs were evaluated for radiographic OA using the Kellgren-Lawrence classification and the OA Research Society International (OARSI) atlas. The association of factors with the incidence of clinical and radiographic OA was evaluated. Results: Follow up was collected on 28 of 32 eligible patients (87.5%) at a mean follow up of 2.46 years (range 2.05-3.76 years). At time of surgery, mean age was 44.6 years and mean BMI was 32.7. At follow-up, two patients had undergone subsequent surgery (7%). 14 patients (50.0%) met KOOS criteria for clinical OA. Among the 11 patients with available follow up radiographs, 4 (36%) met OARSI atlas criteria for knee OA. For medial posterior root tears, patients over the age of 45 with BMI over 35 were significantly more likely to develop clinical (85.7% versus 35.0%, p=0.033) and radiographic OA (80.0% versus 0.0%, p=0.015), and undergo additional surgery (40% versus 0%, p=0.036). Conclusion: Arthroscopic repair of posterior root tears in a North American population has a low rate of subsequent surgery despite developing clinical and radiographic OA. Older and heavier patients have a higher incidence of clinical and radiographic OA. Further study is needed to determine optimal treatment for root tears in these patients. [Table: see text]