bluuebunny/crossref_metadata_2025_split huggingface dataset:
Age-Stratified Assessment of the Impact of Breast Cancer Knowledge on the Lifestyle and Dietary Patterns Among Nigerian Females
Authors: Effiong Magdalene Eno , Afolabi Israel Sunmola , Chinedu Shalom Nwodo 
Published: August 2024

PURPOSE Breast cancer (BC) is a major cause of cancer-related mortality in Nigeria, which is exacerbated by a lack of understanding of how knowledge of BC risk factors influences the lifestyle and dietary patterns of Nigerians across age groups. This study evaluated the influence of knowledge of BC risks on lifestyle and dietary patterns across age groups, aiming to inform early management, prevention, and survival rates. METHODS A cross-sectional survey was conducted in Ota, Ado-odo, Ogun State, Nigeria, involving participants from six educational institutions. The study assessed knowledge of BC risks factors and lifestyle/dietary habits using questionnaires. Results were analyzed using Epi Info software and SPSS version 20. RESULTS The participants' age ranged from 13 to 60 years, with a mean of 21 years. The age categories of the participants were 75.24% adolescents (13-19), 18.68% young adults (20-40), and 6.08% middle-aged (41-60). Middle-aged individuals had the least knowledge about smoking (7.58%), alcohol (26.09%), antibiotics (7.25%), and red meat/smoked foods (20.09%), which translated into their poor dietary/lifestyle patterns. Young adults showed profound physical inactivity (71.00%), while adolescents consumed more carbonated drinks (71.53%), which corresponded to lack of knowledge about the effects of physical inactivity (10.85%) and consumption of carbonated drinks (13.70%) on BC risk. CONCLUSION The study found that understanding BC risk factors directly affects lifestyle and dietary patterns. Age groups with higher knowledge had better lifestyle/dietary patterns. This highlights the need for a tailored intervention on lifestyle and dietary education across all age groups, especially the middle-aged, so as to inform a deliberate adjustment in lifestyle and dietary habits, which play crucial roles in BC incidence, survival, and prevention.
Association of Opioid Disposal Practices with Parental Education and a Home Opioid Disposal Kit Following Pediatric Ambulatory Surgery
Authors: Stone Amanda L. , Favret Lacie H. , Luckett Twila , Nelson Scott D. , Quinn Erin E. , Potts Amy L. , Eden Svetlana K. , Patrick Stephen W. , Bruehl Stephen , Franklin Andrew D. 
Published: August 2024

BACKGROUND:
The majority of opioid analgesics prescribed for pain after ambulatory pediatric surgery remain unused. Most parents do not dispose of these leftover opioids or dispose of them in an unsafe manner. We aimed to evaluate the association of optimal opioid disposal with a multidisciplinary quality improvement (QI) initiative that proactively educated parents about the importance of optimal opioid disposal practices and provided a home opioid disposal kit before discharge after pediatric ambulatory surgery.

METHODS:
Opioid disposal behaviors were assessed during a brief telephone interview pre- (Phase I) and post-implementation (Phase II) after surgery. For each phase, we aimed to contact the parents of 300 pediatric patients ages 0 to 17 years who were prescribed an opioid after an ambulatory surgery. The QI initiative included enhanced education and a home opioid disposal kit including DisposeRX®, a medication disposal packet that renders medications inert within a polymeric gel when mixed with water. Weighted segmented regression models evaluated the association between the QI initiative and outcomes. We considered the association between the QI initiative and outcome significant if the beta coefficient for the change in intercept between the end of Phase I and the beginning of Phase II was significant. Safe opioid disposal and any opioid disposal were evaluated as secondary outcomes.

RESULTS:
The analyzed sample contained 161 pediatric patients in Phase I and 190 pediatric patients in Phase II. Phase II (post-QI initiative) cohort compared to Phase I cohort reported higher rates of optimal (58%, n = 111/190 vs 11%, n = 18/161) and safe (66%, n = 125/190 vs 34%, n = 55/161) opioid disposal. Weighted segmented regression analyses demonstrated significant increases in the odds of optimal (odds ratio [OR], 26.5, 95% confidence interval [CI], 4.0–177.0) and safe (OR, 4.4, 95% CI, 1.1–18.4) opioid disposal at the beginning of Phase II compared to the end of Phase I. The trends over time (slopes) within phases were nonsignificant and close to 0. The numbers needed to be exposed to achieve one new disposal event were 2.2 (95% CI, 1.4–3.7]), 3.1 (95% CI, 1.6–7.4), and 4.3 (95% CI, 1.7–13.6) for optimal, safe, and any disposal, respectively.

CONCLUSIONS:
A multidisciplinary approach to educating parents on the importance of safe disposal of leftover opioids paired with dispensing a convenient opioid disposal kit was associated with increased odds of optimal opioid disposal.
“NUMA FOLHA QUALQUER EU DESENHO UM SOL AMARELO”: UM PROJETO EDUCACIONAL NUMA SALA DE AULA DE ALUNOS COM DEFICIÊNCIA MÚLTIPLA ASSOCIADA A DEFICIÊNCIA VISUAL.
Authors: Santos Mariana dos Reis 
Published: August 2024

Este resumo consiste num relato de experiência de uma professora de escola especializada em deficiência visual, mediante a culminância do projeto pedagógico “Aquarela”. O perfil educacional nesta sala de aula se configurava no atendimento de estudantes de deficiência visual associada a deficiências múltiplas.Deste modo, a professora em questão priorizou a construção de uma prática pedagógica transformadora e inclusiva, através de metodologias educativas relacionadas a concepção freiriana de “ temas geradores” na construção do conhecimento. Por isso, tal estudo objetivou descrever ações pedagógicas surgidas a partir da necessidade de uma abordagem lúdica, utilizando elementos referentes a letra da canção do compositor Toquinho. Foram realizadas diferentes abordagens pedagógicas em sala de aula. Para tal desdobramento, a professora utilizou metodologias que abordassem diversas formas de comunicação verbais ou não verbais, evidenciando os elementos sociais do cotidiano dos estudantes e desenvolvendo os sentidos corporais ao longo das atividades. Por fim, tal este estudo procurou desconstruir o esteriótipo de barreiras limitantes da construção do processo de ensino aprendizagem dos alunos com deficiência múltipla em sala de aula.Em suma,o projeto centralizou no conjunto de suas ações e execução em sala de aula, a necessidade da mediação crítica no atendimento de alunos com especificidades singulares no espaço educativo,buscando garantir a defesa de uma educação inclusiva, democrática e plural .
THE EVALUATION OF TOTAL HIP ARTHROPLASTY IN THE MANAGEMENT OF SPASTIC PAINFUL HIP DISLOCATION IN CEREBRAL PALSY
Authors: Sionek A. , Bąbik B. , Czubak J. 
Published: August 2024

Spasticity used to be considered a contraindication for total hip replacement (THR) procedures. Due to the development of implants as well as surgical skills, THR became an option for the treatment of painful dislocation of the hip joint in patients with spastic plegia. The aim of this study was an evaluation of mid-term results of THR in spastic CP adolescent patients with painful hips with hip joint subluxation or dislocation.In 2014–2022, 18 pts (19 hips) with CP aged 16 to 20 years underwent THR in our department. The mean follow-up was 4 years (range: 1 – 9 years). Results were evaluated using the Gross Motor Function Scale, VAS scale in accordance with the Ashworth scale, types of implants used (dual mobility cup and not dual mobility cup), and radiological assessment (Crowe scale). Complications have been thoroughly analyzed.In 10 pts there has been an improvement in the GMFSC scale average from 1 to 2 points observed after the surgery. All pts have improved in the VAS scale average of 8 points (from 10 to 7). According to the Crowe scale repositioning of preoperative dislocation to primary acetabulum was achieved in all cases. Complications occurred in 4 cases: dislocations of 2 THR with dual mobility cup and 2 THR with non-dual mobility cup requiring revision surgery with good final result. No statistical significance was noted according to the type of cup (Mann-Whitney U Test).The most important risk factor for complications is severe spasticity. We believe, that CP pts with painful hips should be treated using THR. We didn't observe any significant differences between the types of implants.These findings may serve as a basis for the prediction of outcomes of THR treatment in this specific group of pts.Level of evidence: Case-control or retrospective comparative study-Level III
FEMORAL HEAD REDUCTION OSTEOTOMY APPROACH FOR SEVERE PROXIMAL FEMUR DEFORMITIES: SURGICAL TECHNIQUE AND MINIMUM TWO-YEAR RESULTS
Authors: Rego P. , Mafra I. , Viegas R. , Silva C. , Ganz R. 
Published: August 2024

Executing an extended retinacular flap containing the blood supply for the femoral head, reduction osteotomy (FHO) can be performed, increasing the potential of correction of complex hip morphologies. The aim of this study was to analyse the safety of the procedure and report the clinical and radiographic results in skeletally mature patients with a minimum follow up of two years.Twelve symptomatic patients (12 hips) with a mean age of 17 years underwent FHO using surgical hip dislocation and an extended soft tissue flap. Radiographs and magnetic resonance imaging producing radial cuts (MRI) were obtained before surgery and radiographs after surgery to evaluate articular congruency, cartilage damage and morphologic parameters. Clinical functional evaluation was done using the Non-Arthritic Hip Score (NAHS), the Hip Outcome Score (HOS), and the modified Harris Hip Score (mHHS).After surgery, at the latest follow-up no symptomatic avascular necrosis was observed and all osteotomies healed without complications. Femoral head size index improved from 120 ± 10% to 100 ± 10% (p<0,05). Femoral head sphericity index improved from 71 ± 10% before surgery to 91 ± 7% after surgery (p<0,05). Femoral head extrusion index improved from 37 ± 17% to 5 ± 6% (p< 0,05). Twenty five percent of patients had an intact Shenton line before surgery. After surgery this percentage was 75% (p<0,05). The NAHS score improved from a mean of 41 ± 18 to 69 ± 9 points after surgery (p< 0,05). The HOS score improve from 56 ± 24 to 83 ± 17 points after surgery (p< 0,05) and the mHHS score improved from 46 ± 15 before surgery to 76 ± 13 points after surgery (p< 0,05).In this series, femoral head osteotomy could be considered as safe procedure with considerable potential to correct hip deformities and improve patients reported outcome measures (PROMS).Level of evidence - Level IV, therapeutic studyKeywords - Femoral head osteotomy, Perthes disease, acetabular dysplasia, coxa plana
COLLARED STEMS ARE A PROTECTIVE FACTOR AGAINST EARLY PERIPROSTHETIC FRACTURES IN TOTAL HIP ARTHROPLASTY: A MULTIVARIATE ANALYSIS IN A COHORT OF 1,623 PATIENTS
Authors: Lustig S. , Batailler C. 
Published: August 2024

The stem design in total hip arthroplasty (THA) is constantly evolving. The impact of the collar on the risk of periprosthetic fracture remains controversial. This study aimed to determine whether adding a collar to the femoral stem impacts the early periprosthetic fracture risk within 90 days of surgery.This retrospective study included 1,623 patients who underwent primary total hip arthroplasty in a single orthopedic department between January 2010 and December 2020. The inclusion criteria were uncemented stem with or without a collar, in a primary intention, without previous hip surgery with a similar “corail like” design. The assessed data were demographic characteristics (age, gender, number of obese (BMI > 30)), single or dual mobility, the surgical approach, the early complication, particularly the periprosthetic femoral fractures. Of the 1,623 patients, 1,380 received a collared stem (85%), and 243 received a collarless stem (15%). A multivariate analysis was performed to determine the collar's effect on the risk of early periprosthetic fracture (<90 days).Nine (0.55%) early periprosthetic fractures were identified in the whole cohort. There were four fractures (1.65%) in the collarless stem group and five fractures (0.36%) in the collared stem group (p=0,005). One patient required revision surgery in the collared stem group, while two patients required revision surgery in the collarless stem group. The multinomial logistic regression model indicated a statistically significant lower (p<0.05) risk of early periprosthetic fracture within 90 days of surgery in the collared stems group. No other risk factor for early periprosthetic fractures has been identified.Using collared stems in cementless THA protects early periprosthetic femoral fractures within 90 days of surgery.
INCIDENCE OF POSTOPERATIVE PERIPROSTHETIC FEMORAL FRACTURES USING SHORT STEMS IN TOTAL HIP ARTHROPLASTY
Authors: Falez F. , Casella F. , Zaccagno S. 
Published: August 2024

Post-operative peri-prosthetic femoral fracture (PO-PPFF) is one of the most relevant complications in primary Total Hip Arthroplasty (pTHA), accountable for a significant clinical and socio-economic burden both in revision and fixation settings.We retrospectively reviewed of our series of 1586 cementless total hip arthroplasty performed between 1999 and 2019 (achieving a minimum of 5-years follow-up) with different short stems.We have observed a cumulative low incidence of PO-PPFF of 0,33% (5 cases): we divided Po-PPFF in two groups: fracture occurred around a short stem (A) and around a standard shortened stem (B), according to French Hip & Knee Classification of Short Stems.Despite the length of observed period (mean follow-up 12 years, min 5 years max 24 years) a total of 1512 cases (mean age at surgery 61 years, max 74, min 40 years) were available to clinical and radiographic follow-up, being this population enrolled in elective surgery clinical protocols.Our data exceed the low incidence of post-operative femoral fracture around bone -preserving previously reported by Kim in 2018 (12 fracture out of 1089 cases:1.1%).No correlation have been observed among occurrence of PO-PPF age of the patient and no fracture occurred around cemented short stems despite patient's characteristics were unfavourable in term of age and bone quality. This result is not unexpected, giving the lower incidence of peri-prosthetic fracture even cemented conventional stems, as reported in all registry and systematic reviews.A similar behaviour was reported in 2020 Australian Joint Registry, where Post-operative periprosthetic femoral fracture showed a steep curve in early period, but remaining firmly below 1% during the following 12 years.Our clinical data seems to confirm previous studies by Jones (conducted on synthetic bone and fresh-frozen cadaveric femurs) where higher fracture angles and higher fracture torque were detected in short hips compared to standard stems.
MANAGEMENT OF CHRONIC PELVIC DISCONTINUITY DURING REVISION HIP ARTHROPLASTY USING THE “ACETABULAR DISTRACTION TECHNIQUE”: CLINICAL AND RADIOLOGICAL OUTCOMES AT TWO TO TEN YEARS FROM A TWO-CENTRE STUDY
Authors: Malhotra R. , Parameswaran A. , Gautam D. , Batra S. , Apsingi S. , Kishore V. , Eachempati K. K. 
Published: August 2024

Chronic pelvic discontinuity (CPD) during revision hip arthroplasty is a challenging entity to address. The aim of this study was to evaluate the clinical and radiologic outcomes, and complications of the “acetabular distraction technique” for the management of CPD during revision hip arthroplasty.Patients with CPD, who underwent acetabular revision between 2014 and 2022 at two tertiary care centres, using an identical distraction technique, were evaluated. Demographic parameters, pre-operative acetabular bone loss, duration of follow-up, clinical and radiologic outcomes, and survivorship were evaluated.In all, 46 patients with a mean follow-up of 34.4 (SD=19.6, range: 24–120) months were available for evaluation. There were 25 (54.3%) male, and 21 (45.7%) female patients, with a mean age of 58.1 (SD=10.5, range: 40–81) years at the time of revision surgery. Based on the Paprosky classification of acetabular bone loss, 19 (41.3%), 12 (26.1%), and 15 (32.6%) patients had type 3b, 3a, and 2c defects. All patients were managed using the Trabecular Metal™ Acetabular Revision System; 16 patients required additional Trabecular Metal™ augments. The mean HHS improved from 50.1 (SD=7.6, range: 34.3 – 59.8) pre-operatively, to 86.6 (SD=4.2, range: 74.8 -91.8) at the last follow-up. Two patients (4.3 %) developed partial sciatic nerve palsy, two (4.3%) had posterior dislocation, and one (2.2%) required re-revision for aseptic loosening. Radiologically, 36 (78.3%) patients showed healing of the pelvic discontinuity. The Kaplan-Meier construct survivorship was 97.78% when using re-revision for aseptic acetabular loosening as an endpoint.The acetabular distraction technique has good clinical and radiologic outcomes in the management of CPD during revision hip arthroplasty.
THE PUSH-THROUGH TOTAL FEMORAL PROSTHESIS FOR REVISION OF A TOTAL HIP OR KNEE ARTHROPLASTY WITH EXTREME BONE LOSS
Authors: Bakircioglu S. , Bulut M. Abdulkadir , Oral M. , Caglar O. , Atilla B. , Tokgozoglu A. M. 
Published: August 2024

Extensive and severe bone loss of the femur may be a result of a failed total hip arthroplasty (THA) or total knee arthroplasty (TKA) with multiple revision surgeries which may be caused by factors such as infection, periprosthetic fracture or osteolysis. The aim of this study was to assess outcomes of using the “Push-Through Total Femoral Prosthesis” (PTTF) for revision of a total hip replacement with extreme bone loss.Fourteen patients who had extensive bone defects of the femur due to failed THR's and were treated with PTTF between 2012 and 2020 were included in this study. Primary functional outcomes were assessed using Harris Hip Score (HHS), Toronto Extremity Salvage Score (TESS) and Musculoskeletal Tumor Society (MSTS) scores. Range of motion, complications, and ambulatory status were also recorded to assess secondary outcomes.Two of 14 patients underwent surgery with PTTF for both knee and hip arthroplasty revision. The mean time between index surgery and PTTF was 15 years (3 to 32 yrs.). Acetabular components were revised in six of 14 patients. After a mean follow-up of 5.9 years, hip dislocations occurred in 3 patients. All dislocated hips were in patients with retained non-constrained acetabular bearings. Patient satisfaction was high (MSTS: 67%, HHS: 61.2%, TESS 64.6%) despite a high re-operation rate and minor postoperative problems.PTTF is a unique alternative that may be considered for a failed THA revision procedure in patients with an extreme femoral bone defect. Patients are able to ambulate pain free relatively well. Routine usage of constrained liners should be considered to avoid hip dislocation which was our main problem following the procedure.
THE FIRST 200 CERAMIC-ON-CERAMIC HIP RESURFACING IMPLANTS AT MINIMUM TWO-YEAR FOLLOW-UP
Authors: Walter W. , Lin D. , Weinrauch P. , de Smet K. , Beaule P. , Young D. , Xu J. , Manktelow A. 
Published: August 2024

Hip resurfacing arthroplasty (HRA) is a bone conserving alternative to total hip arthroplasty. We present the early 2-year clinical and radiographic follow-up of a novel ceramic-on-ceramic (CoC) HRA in an international multi-centric cohort.Patients undergoing HRA between September 2018 and January 2021 were prospectively included. Patient-reported outcome measures (PROMS) in the form of the Forgotten Joint Score (FJS), HOOS Jr, WOMAC, Oxford Hip Score (OHS) and UCLA Activity Score were collected preoperatively and at 1- and 2-years post-operation. Serial radiographs were assessed for migration, component alignment, evidence of osteolysis/loosening and heterotopic ossification formation.200 patients were identified to have reached 2-year follow-up. Of these, 185 completed PROMS follow-up at 2 years. There was significant improvement in HOOS (p< 0.001) and OHS (p< 0.001) and FJS (p< 0.001) between the pre-operative and 2-year outcomes. Patients reported improved pain (p<0.001), function (p<0.001) and reduced stiffness (p<0.001) as measured by the WOMAC score. Patients had improved activity scores on the UCLA Active Score (P<0.001) with 53% reporting return to impact activity at 2 years. There was no osteolysis and the mean acetabular cup inclination angle was 41deg and the femoral component shaft angle was 137deg. No fractures were reported over but there was one sciatic nerve palsy with partial recovery. Two patients were revised; one at 3 months for pain due to a misdiagnosed back problem and another at 33 months for loosening of the acetabular component with delamination of the titanium ingrowth surface.CoC resurfacing at 2-years post-operation demonstrate promising results with satisfactory PROMS.
DOES REVISION ACCURATELY CORRECT LEG LENGTH DISCREPANCY AFTER TOTAL HIP ARTHROPLASTY? FUNCTIONAL OUTCOMES AND COMPLICATION RATES IN 57 PATIENTS
Authors: Hormi-Menard M. , Wegrzyn J. , Girard J. , Faure P-A. , Duhamel A. , Erivan R. , Migaud H. 
Published: August 2024

The results of total hip arthroplasty (THA) revisions to correct leg length discrepancy (LLD) are not clear, with only two former limited series (< 25 patients). Therefore, we conducted a retrospective study of THA revisions for LLD to determine: 1) the change in LLD, 2) the function outcomes and whether obtaining equal leg lengths influenced function, 3) the complication and survival rates.This multicenter study included 57 patients: 42 THA revisions for limb shortening and 15 revisions for limb lengthening. LLD was measured on conventional radiographs and EOS. The Oxford-12 and FJS outcome scores were collected and the number of patients achieving the Oxford-12 MCID.The revisions were carried out a mean of 2.8 years after the index THA. The median LLD decreased from 7.5 mm (IQR: [5;12]) to 1 mm (IQR: [0.5;2.5]) at follow-up (p=0.0002). Overall, 55 of 57 patients (96%) had < 5 mm LLD at follow-up and 12 patients (21%) had equal leg lengths. The complication rate was 25%: 12 mechanical complications (8 periprosthetic femoral fractures, 2 stem loosening and 1 cup loosening, 1 dislocation) and 1 periprosthetic infection. The patient satisfaction was high with a median FJS of 79.2/100 and 77% of patients reached the Oxford-12 MCID. Lengthening procedures had significantly worst function than shortening (38% vs 91% of patients achieving the Oxford-12 MCID (p=0.0004)). Survivorship was 85% (95% CI: 77.9 – 92.5) at 2 years and 77% (95% CI: 66.3 – 87.1) at 4.6 years when using re-revision for any reason as the endpoint.When LLD after THA does not respond to conservative management, revision THA should be considered. Although revision THA for LLD improved medium-term functional outcomes with a high patient satisfaction rate, especially for shortening procedures, the complication rate was high, particularly related to periprosthetic femoral fracture.