bluuebunny/crossref_metadata_2025_split huggingface dataset:
Various plus unique: Viral protein U as a plurifunctional protein for HIV-1 replication
Authors: Soper Andrew , Juarez-Fernandez Guillermo , Aso Hirofumi , Moriwaki Miyu , Yamada Eri , Nakano Yusuke , Koyanagi Yoshio , Sato Kei 
Published: March 2017

Human immunodeficiency virus type 1 (HIV-1), the causative agent of acquired immunodeficiency syndrome, encodes four accessory genes, one of which is viral protein U (Vpu). Recently, the study of Vpu has been of great interest. For instance, various cellular proteins are degraded (e.g. CD4) and down-modulated (e.g. tetherin) by Vpu. Vpu also antagonizes the function of tetherin and inhibits NF-κB. Moreover, Vpu is a viroporin forming ion channels and may represent a promising target for anti-HIV-1 drugs. In this review, we summarize the domains/residues that are responsible for Vpu’s functions, describe the current understanding of the role of Vpu in HIV-1-infected cells, and review the effect of Vpu on HIV-1 in replication and pathogenesis. Future investigations that simultaneously assess a combination of Vpu functions are required to clearly delineate the most important functions for viral replication. Impact statement Viral protein U (Vpu) is a unique protein encoded by human immunodeficiency virus type 1 (HIV-1) and related lentiviruses, playing multiple roles in viral replication and pathogenesis. In this review, we briefly summarize the most up-to-date knowledge of HIV-1 Vpu.
Pre-operative urinary tract infection: is it a risk factor for early surgical site infection with hip fracture surgery? A retrospective analysis
Authors: Yassa Rafik RD , Khalfaoui Mahdi Y , Veravalli Karunakar , Evans D Alun 
Published: March 2017

Objective The aims of the current study were to determine whether pre-operative urinary tract infections in patients presenting acutely with neck of femur fractures resulted in a delay to surgery and whether such patients were at increased risk of developing post-operative surgical site infections. Design A retrospective review of all patients presenting with a neck of femur fracture, at a single centre over a one-year period. The hospital hip fracture database was used as the main source of data. Setting UK University Teaching Hospital Participants All patients ( n = 460) presenting across a single year study period with a confirmed hip fracture. Outcome measures The presence of pre-operative urinary tract infection, the timing of surgical intervention, the occurrence of post-operative surgical site infection and the pathogens identified. Results A total of 367 patients were operated upon within 24 hours of admission. Urinary infections were the least common cause of delay. A total of 99 patients (21.5%) had pre-operative urinary tract infection. Post-operatively, a total of 57 (12.4%) patients developed a surgical site infection. Among the latter, 31 (54.4%) did not have a pre-operative urinary infection, 23 (40.4%) patients had a pre-operative urinary tract infection, 2 had chronic leg ulcers and one patient had a pre-operative chest infection. Statistically, there was a strong relationship between pre-operative urinary tract infection and the development of post-operative surgical site infection ( p-value: 0.0005). Conclusion The results of our study indicate that pre-operative urinary tract infection has a high prevalence amongst those presenting with neck of femur fractures, and this is a risk factor for the later development of post-operative surgical site infection.
The effectiveness of telemedicine in the management of chronic heart disease – a systematic review
Authors: Kruse Clemens S , Soma Mounica , Pulluri Deepthi , Nemali Naga T , Brooks Matthew 
Published: March 2017

Objective The primary objective of this systematic review is to assess the effectiveness of telemedicine in managing chronic heart disease patients concerning improvement in varied health attributes. Design This review follows the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) standard. Setting We adopted a logical search process used in two main research databases, the Cumulative Index to Nursing and Allied Health Literature and PubMed (MEDLINE). Four reviewers meticulously screened 151 abstracts to determine relevancy and significance to our research objectives. The final sample in the literature review consisted of 20 articles. Main outcome measures We looked for improved medical outcomes as the main outcome measure. Results Our results indicated that telemedicine is highly associated with the reduction in hospitalisations and readmissions (9 of 20 articles, 45%). The other significant attributes most commonly encountered were improved mortality and cost-effectiveness (both 40%) and improved health outcomes (35%). Patient satisfaction occurred the least in the literature, mentioned in only 2 of 20 articles (10%). There was no significant mention of an increase in patient satisfaction because of telemedicine. Conclusions We concluded that telemedicine is considered to be effective in quality measures such as readmissions, moderately effective in health outcomes, only marginally effective in customer satisfaction. Telemedicine shows promise on an alternative modality of care for cardiovascular disease, but additional exploration should continue to quantify the quality measures.
Early Results of the Medial Approach for Arthroscopic-Assisted Fixation of Lateral Tibial Plateau Fractures
Authors: Erden Tunay , Batar Suat , Uzer Gökçer , Kurdal Demet Pepele , Elmalı Nurzat 
Published: March 2017

The use of arthroscopy in the management of tibial plateau fractures is not a particularly new concept. It has been used successfully for Schatzker types I–III fractures. In addition to evaluating the fracture itself, it is easier to evaluate the other intraarticular structures. Coventionally, reduction for lateral tibial plateau fractures have been performed through a laterally based metaphyseal window, which is not without limitations, including difficulty with reduction of the fracture, as well as bone grafting though the resultant short subchondral tunnel. Also, there is a risk of lateral vascular supply distrubtion because of same side fracture. A medially based metaphyseal window to approach lateral tibial plateau fractures allows for minimal insult to the soft tissues, with advantageous ease of reduction and grafting through a longer tunnel for subchondral support. We aimed to present our initial experiences in twelwe cases approaching lateral tibial plateau fractures through a medial metaphyseal window. Material-Methods: Our series involves 12 patients with 7 Schatzker type II, 3 Schatzker type I, and 2 Schatzker type III fractures. There were 8 males and 4 females. The average age at the time of surgery was 37 (25-57) years. All of the patients underwent plain radiography and BT in each knee Time from injury to surgery was 6.2 days. Follow up was 18 months (9-22 months).Firstly diagnostic arthroscopy was performed. Concomittant pathology was adreessed as needed. There was 3 lateral meniscus tear that treated with partial meniscectomy. An ACL guide pin was placed percutaneously anteromedial tibia approximately 9 cm distal to the joint line. Once stisfactory positioning a cortical window 1x2 cm. made around the guide pin. Reduction was accomplished with a bone tamp that fits easily into the tunnel. Screws were used as rafters to support the articular surface and subchondral bone. We used in 7 patients lateral plate and screws and in 5 patients only screws. Care was taken to keep pump pressure at approximately 40 millimeters of mercury for alleviate the risk of compartment syndrome. Results: No complications related to the procedure were observed. No secondary loss of reduction was observed in radiological controls. Functional assessment according to HSS of the patients were excellent in 5 cases, good in 5 cases and fair 2 cases. Discussion: Because depressed fragments are elevated from distal cortical windows, the importance of an intact, or easily restored, “cortical envelope” is paramount. This case series showed satisfactory early clinical results. [Figure: see text][Figure: see text]
The Effects of Tunnel Position in Patients Who Underwent the Anterior Cruciate Ligament Reconstruction with Transfix Method on the Clinical and Functional Results
Authors: Öz Tayyar Taylan , Akan Kaya , Esenkaya İrfan , Erinç Samet , Özturan Burak , Yayla Mehmet Ali 
Published: March 2017

Objective: The aim of this study is to analyse the effects of femoral and tibial tunnel localization in the sagittal plane in the patients who underwent the anterior cruciate ligament reconstruction with transfix method in our clinic on the clinical and functional results. Methods: 36 patients underwent the anterior cruciate ligament reconstruction performed by different surgeons with the same method between January 2010 and December 2014 in Istanbul Medeniyet University Goztepe Training and Research Hospital Orthopaedics and Traumatology Clinic. Femoral and tibial tunnel localization was conducted on the lateral radiography of the knee of the patients. The clinical evaluations of the patients were carried out with lysholm score, IKDC score, tegner activity score, extensor and flexor measured by CYBEX CSMI dynamometer for muscular strength loss. Results: It was observed that femoral tunnel positions of 47.2% (n=17) of the patients were at the intended location while the ones of 52.8% (n=19) were in anterior. Tibial tunnel positions of 52.8% (n=19) of the patients were at the intended location while the ones of 33.3% (n=12) were in anterior, and the ones of 13.9% (n=5) were in posterior. The postoperative lysholm scores of F (+) T (+) group were significantly higher than F (+) T (-) (p=0.004), F (-) T (+) (p=0.004) and F (-) T (-) (p=0.004) groups. The postoperative IKDC score normality of F (+) T (+) group were significantly higher than F (-) T (+). The postoperative tegner measurements of F (+) T (+) group were significantly higher than F (-) T (+). The measurements of extensor deficit of F (+) T (+) (p=0.022) group and F (+) T (-) (p=0.049) group were significantly lower than F (-) T (-) group. The measurements of flexor deficit of F (+) T (+) group were significantly lower than F (-) T (+) (p=0.011) group and F (-) T (-) (p=0.040) group and F (+) T (-) group of flexor deficit measurements significantly lower than F (-) T (+) group (p=0.028) (p<0.05). Conclusion: Misplacement of femoral and tibial tunnels has negative effects on clinic functional results. While misplacement of tibial tunnel can be tolerated better, the placement of femoral tunnel in anterior cannot be tolerated and has further effects on the results.
Is it possible to avoid posterior tibial slope increase in open-wedge high tibial osteotomy?
Authors: Kaya Hüseyin , Kayabiçer Elcil , Daştan Ali Engin , Taşkıran Emin 
Published: March 2017

Aim: Posterior tibial slope has shown to be increased with open-wedge high tibial osteotomy (OWHTO) which may lead to an increase in loading of the anterior cruciate ligament and causing patellofemoral problems in return. In this case series, patients with an OWHTO performed posteromedial to the medial collateral ligament (MCL), keeping it intact was investigated. The aim of this study was to evaluate the influence of this technique on the posterior tibial slope. Methods: Thirty knees (15 right, 15 left) of 28 patients (22 women, 6 men) with a mean age of 53.57±5.9 years who had an OWHTO between January 2014 and February 2016 were included in this study. Surgical technique: A proximal tibial osteotomy is performed posteromedial to MCL keeping it intact. Following the osteotomy, distraction is also performed from the posteromedial aspect of tibia. Fixation is achieved utilizing TomoFix plate. Radiological evaluation: Preoperative and postoperative mechanical axes (MA) were measured on standard weight bearing long axis x-rays. Preoperative and postoperative posterior tibial slope angles were measured on lateral x-rays using three different Methods: the angles between medial tibial plateau and (1) posterior tibial cortex, (2) tibial proximal anatomical axis, and (3) posterior fibular cortex were measured. The correlations of three different measurement methods were analyzed. Patients were grouped according to preoperative MA deviations and postoperative MA changes (either <10º or >=10º). The posterior tibial slope changes were compared between groups. Statistical analyses: All statistical analyses were performed utilizing SPSS 18.0. Results: Mean preoperative and postoperative MA deviations were 9.81°±4.94° and -2.72°± 2.69° respectively. The mean correction angle of MA of lower extremity was 12.62°±4.58°. The three methods used to measure the posterior tibial slope angles were found to be highly correlated with each other ((1) and (2) r=0.961; (1) and (3) 0.906; (2) and (3) 0.934; p values <0.0001). Preoperative mean posterior tibial slope angles were 9.50º±4.47°, 11.51º± 4.50°, and 10.80º±4.58°; postoperative angles were 6.10º±4.23°, 8.78º±4.57° and 8.11º±4.55°, respectively. Posterior tibial slope angle was significantly decreased postoperatively with respect to all three methods (p <0.0001). The changes in the posterior tibial slope was not statistically significant between the groups with preoperative <10º and >=10º deformities (p values 0.861, 0.723, 0.727, respectively). Conclusions: Posterior tibial slope was found to be decreased with this posteromedial OWHTO technique. This technique offered the advantage of preserving the posterior tibial slopes postoperatively even in highly deformed knees which necessitated higher degrees of corrections in the mechanical axes.
Transtibial repair in medial meniscus root avulsions; 2 years clinical results
Authors: Kaya Alper , Ülkü Tekin Kerem , Karagüven Doğaç , Kocaoğlu Barış 
Published: March 2017

Introduction: Medial meniscus posterior root avulsion injuries exhibited a similar extent of increasing contact pressure and decreasing contact area, as that in the total meniscectomized knee and resulting articular cartilage loss in medial compartment of the knee joint. Although partial meniscectomy is the traditional treatment in symptomatic posterior root avulsions, this method can not restore cartilage loss. The recommended surgical treatment for posterior root avulsions is repair in non degenerated knees. Patients and methods: Arthroscopic transtibial repair was performed in 11 patients who were diagnosed as symptomatic posterior root avulsions with clinical examination and magnetic resonance imaging findings and minimum 2 years results were evaluated. There were 8 women and 3 men, and the mean age of the patients were 51 (46-58). The mean time interval between injury and surgery was 4 weeks (5 days and 8 weeks). Conservative treatment was given to all of patients except one, and surgical treatment was performed for patients whose mechanical sypmtoms and pain weren’t relieved at the end of conservative treatment. The repair method was arthroscopic pull-out technique with fixation of the posterior attachment area through a tibial tunnel. Walking 4-6 weeks non-weight bearing with two crutches and physical treatment was given that includes muscle strengthening and range of motion exercises. Patients were evaluated with preoperative and 2 years postoperative Lysholm knee scores, clinical examination and radiographic changes. Results: Mean Lysholm scores were increased preoperative from 55 to postoperative 86 that was found statictically significant. In ten patients complaints were resolved after surgical treatment and daily living began normally after surgery. In one patient arthroscopic partial meniscectomy was done due to rerupture after five months from index surgery. In two patients medial joint space narrowing was found radiologically at the end of two years but there were no clinical complaints. Conclusions: Repair must be considered in symptomatic medial meniscus posterior root avulsions also in older age if there is no degenerative osteoarthritis. The root tear that has similar effects as total meniscectomy will cause cartilage loss if not treated.
Meta-analysis of epidural analgesia versus peripheral nerve blockade after total knee joint replacement
Authors: Toner Ethan , Elmuntasar Ahmed , Mceleny Dearbhla , Gerrard Adam Daniel , Hajibandeh Shahab , Hajibandeh Shahin 
Published: March 2017

Background: Postoperative pain after major knee surgery can be severe. Our aim was to compare the outcomes of epidural analgesia and peripheral nerve blockade (PNB) in patients undergoing total knee joint replacement (TKR). Moreover, we aimed to compare outcomes of adductor canal block (ACB) with those of femoral nerve block (FNB) after TKR. Methods: We conducted a systematic search of electronic information sources, including MEDLINE; EMBASE; CINAHL; and the Cochrane Central Register of Controlled Trials (CENTRAL). We applied a combination of free text and controlled vocabulary search adapted to thesaurus headings, search operators, and limits in each of the above databases. Pain intensity assessed on visual analogue scale (VAS), nausea and vomiting, systolic hypotension, and urinary retention was the reported outcome parameters. Results: We identified 12 randomised controlled trials (RCTs) comparing outcomes of epidural analgesia and PNB reporting a total of 670 patients. There was no significant difference between two groups in VAS scores at 0–12 h (MD -0.48; 95% CI -1.07–0.11, P = 0.11), 12–24 h (MD 0.04; 95% CI -0.81–0.88, P = 0.93), and 24–48 h (MD 0.16; 95% CI -0.08–0.40, P = 0.19). However, epidural analgesia was associated with significantly higher risk of postoperative nausea and vomiting (RR 1.65; 95% CI, 1.20–2.28, P = 0.002), hypotension (RR 1.76; 95% CI, 1.26–2.45, P = 0.0009), and urinary retention (RR 4.51; 95% CI, 2.27–8.96, P<0.0001) compared to PNB. Moreover, pooled analysis of data from 6 RCTs demonstrated no significant difference in VAS score between ACB and FNB at 24 h (MD -0.00; 95% CI, -0.56–0.56, P = 0.99) and 48 h (MD -0.06; 95% CI, -0.14–0.03, P = 0.23). Conclusions: PNB is as effective as epidural analgesia for postoperative pain management in patients undergoing TKR. Moreover, it is associated with significantly lower postoperative complications. ACB appears to be an effective PNB with similar analgesic effect to FNB after TKR. Future RCTs may provide better evidence regarding knee range of motion, length of hospital stay, and neurological complications.
Superior labrum almost always tears following subscapularis injuries
Authors: Çetinkaya Mehmet , Ataoğlu Muhammet Baybars , Özer Mustafa , Ayanoğlu Tacettin , Kaptan Ahmet Yiğit , Kanatlı Ulunay 
Published: March 2017

Purpose and Hypothesis: The subscapularis tendon is the major medial support of the long head of biceps tendon (LHBT). Thus, tears of subscapularis may cause biceps tendon subluxation or dislocation. A subluxated biceps tendon may cause a superior labrum injury because of the changed direction of the biceps tendon pulling vector. The purpose of this study is to express the frequency of superior labrum anterior posterior (SLAP) lesions accompanying subscapularis tears. Methods: The digital files of 2010 patients who underwent shoulder arthroscopy were reviewed retrospectively. 141 videos of 141 patients with subscapularis tear were examined in terms of superior labrum and biceps tendon injuries by one of the authors in this study. The results were compared with those of all the 2010 patients who underwent shoulder arthroscopy for any reason. The statistical analysis was made with a statistics programme by the Independent Samples T-Test. Results: There were 113 videos on which the superior labrum and LHBT could be examined precisely. Mean age was 57.8 and 66% of the patients were female. 96.4% of the 113 patients were having a SLAP lesion. 10.6% of those were SLAP I and 89.4% were SLAP II lesion. Out of 2010 patients, the SLAP lesion ratio was 32.2% of which 4.9% were SLAP I. That difference between the patients with and without subscapularis tear was statistically significant. Conclusions: Following the loss of medial support, the LHBT and its pulling vector subluxate anteriorly resulting in a tear of the superior labrum from anterior to posterior. In this study, SLAP lesions were strongly correlated with subscapularis tears as well. Furthermore, the synovial hypertrophy initiated after a superior labrum pathology at superior aspect of the glenoid spreads over the LHBT. An inflamed LHBT firstly degenerates, and then ruptures. According to this study, tears of subscapularis should be repaired when encountered in order to prevent the upcoming secondary intra-articular disorders. [Figure: see text]
The relationship between pectoralis minor length, scapular muscle endurance and core endurance in athletes
Authors: Seven Gamze Çobanoğlu , Zorlular Ali , Keklik Sinem Suner , Akaras Esedullah , Gökdoğan Çağatay , Polat Elif Aygün , Kafa Nihan , Güzel Nevin Atalay 
Published: March 2017

Objective: The purpose of this study was to identify relationships between core endurance, scapular muscle endurance and pectoralis minor length in athletes. Methods: 69 professional athletes in different branches (44 men, 25 women, mean age 20.41±5.72, height 176.0±0.1, and weight 68.2±12.8) were included to this study. Pectoralis minor length was measured in supine. In this position linear distance from treatment table to posterior aspect of the acromion was measured. Core endurance was evaluated using Mcgill Core Endurance Tests. Scapular muscle endurance was assessed with scapular endurance test. Statistical analysis was performed using the statistical software SPSS. Results: Spearman correlation analysis results showed that there was correlation between pectoralis minor length and scapular muscle endurance (r=0.281, p<0.05). A positive correlation was found between pectoralis minor length and core endurance (r= 0.517, p<0.05). There was correlation between scapular muscle endurance and core endurance (r=0.524, p<0.05). Conclusions: In this study, it was shown that there were statistically significant relationship between pectoralis minor length, scapular muscle endurance and core endurance. Pectoralis minor length affects scapula biomechanics. Change in scapula biomechanics may cause reduction in scapular muscle endurance. It may affect core endurance via kinetic chain. Therefore, it can be suggested pectoralis minor stretching should be integrated to normal sports specific training programmes in professional athletes.