bluuebunny/crossref_metadata_2025_split huggingface dataset:
Isometry of the lateral, posterolateral and anterolateral knee complex: a cadaveric study
Authors: Cherif Mikael , Bouhali Haroun , Chanteux Lucas , Guerot Maxime , Boukebous Baptiste , Maillot Cédric , Rousseau Marc-Antoine 
Published: March 2022

Objectives: There is no consensus on the insertion points for reconstruction of lateral ligament complex injuries. The aim of this study is to evaluate the relative isometry between easily identifiable bony ridges in order to recommend adequate reconstruction of the external structures: the lateral collateral ligament, the popliteus complex and the anterolateral ligament. Methods: After dissection of the cutaneous and subcutaneous planes of six lower limbs from 3 anatomical subjects, metal markers were fixed on 7 anatomical edges of interest: no. 1: posteroproximal to the lateral epicondyle, within a bony depression - no. 2: at the tip of the lateral epicondyle - no. 3: 18 mm distal and 0.84 mm anterior to the LCL insertion - no. 4: at Gerdy’s tubercle - no. 5: at the anterior part of the fibular head - no. 6: at the posterior part of the fibular head - no. 7: at the popliteal fossa of the tibia, 10 mm medial to the proximal tibiofibular joint, and 10 mm inferior to the joint space. The distance between these points was measured with a caliper at 0, 30, 60 and 90 degrees of flexion in neutral rotation. Results: We noted a decrease in the distance between anatomic femoral and fibular LCL (pair) insertions 1-5 during flexion (63 mm ± 2.6 to 50 mm ± 4.8). The most isometric positions were identified for the following point pairs: 2-5 (57 mm ± 3.4 to 55 mm ± 3), 3-6 (60 mm ± 3.5 to 59 mm ± 3.2), 2-4 (52 mm ± 4.6 to 55 mm ± 2.7) and 3-7 (53 mm ± 6.4 to 52 mm ± 4.6). We noted no difference between knees. Conclusion: These results show that the anatomical structures are not isometric. However, some easily identifiable point pairs of the lateral aspect of the knee show an isometric feature. Therefore, we recommend using pairs 2-5 for the LCL, 2-4 for the ALL and 3-7 for the PC.
Open Latarjet: should there be concern about a SLAP lesion?
Authors: Pillot Sabine , Garcia-Maya Beatriz , Billaud Anselme 
Published: March 2022

Objectives: A SLAP Lesion is present in 20% of the cases of anterior instability and is not treated during an open bone block. The objective of this study is to compare the results after open Latarjet with or without type-V SLAP lesion on imaging, in patients who practice sports. Methods: A retrospective study of 50 patients. Inclusion criteria were participation in sports, anterior unidirectional instability with coracoid bone block procedure, contrast imaging before surgery, and more than 12 months of follow-up. Group 1 had 12 cases of type-V SLAP lesion diagnosed on contrast imaging and control group 2 had 38 cases. Patients were evaluated by Quick-Dash, Rowe, VAS pain and Satisfaction scores by an online questionnaire. Resumption of sports and the level were also evaluated. Results: The mean age was 22 years (16.36 ± 5) and the mean follow-up was 27 months (12.42 ± 9). 34 patients played a contact sport, 20 of whom played rugby. The 2 groups were comparable for the variables of age, gender, number of dislocations, practicing sports, glenoid substance loss and Hill-Sachs lesion. There was no significant difference between the 2 groups for the Quick-Dash and VAS Satisfaction scores. A recurrence such as an incomplete dislocation was reported in each group. The Rowe score was 79 (25,100 ± 23) in group 1 vs 91 (40,100 ± 15) in group 2 (p = 0.018, P = 55%). In the SLAP group, the proportions of patients with no pain and no residual apprehension were lower (50% vs 77%, 50% vs 79%), and sports resumption was less (83% vs 91%) without attaining significance. Conclusion: Patients with type-V SLAP lesion had poorer results after open Latarjet. These results should be confirmed on a larger sample and do not preclude the importance of a complementary procedure for SLAP lesions, the treatment of which remains controversial.
Thrower’s shoulder: 3D Experimental evaluation of scapulothoracic dyskinesia by EOS imaging
Authors: Lacroix Paul Maxime , Billaud Anselme 
Published: March 2022

Objectives: In thrower’s shoulder pathology, scapulothoracic (S) dyskinesia (D) is classified by Kibler in 3 stages. However, the clinical or radiological diagnosis of SD is difficult and not very reproducible. The objective of this study was to evaluate scapular positioning on dry bones using low-dose 3D EOS imaging. Methods: A full-scale dry-bone S model (MODEL) was created which included the 2 scapulae and the thorax. A system of wedges enables adjustment of the right scapula to simulate the 3 stages of SD (MODEL0, MODEL1, MODEL2, MODEL3). Each MODEL was imaged in 7 random positions. The following points were identified by 2 observers: C7, T12, the xiphoid process, the inferomedial angle, the coracoid and the fulcrum. 28 S positioning measurements were taken. Inter- and intra-observer reproducibility were evaluated. Results: The thoracic and scapular points of interest are easily identified except for the fulcrum. The inter- and intra-observer reproducibility of the measurements were 94% and 94% for superior translation, 90% and 87% for protraction, 96% and 96% for anterior tilt, 75% and 86% for internal rotation, and 91% and 91% for lateral rotation. The average difference between the measurements of the 2 observers was -0.1 cm for distances (-3.3; 0.5; +/- 0.5) and -0.3° for angles (-8; 13; +/- 2.8). Conclusion: Bi-planar EOS imaging allows simple reproducible measurement of S positioning on dry bone. It could be used for diagnostic evaluation and quantification of SD. Low irradiation could play a role in the therapeutic follow-up. The potential in clinical use is yet to be confirmed.
The natural long-term course of unrepaired ramp lesion: a retrospective analysis of 28 patients followed for at least 20 years
Authors: Fayard Jean-Marie , Tuphe Pierre , Freychet Benjamin , Sonnery-Cottet Bertrand , Chambat Pierre , Thaunat Mathieu , Unal Pauline 
Published: March 2022

Objectives: Ramp lesion is a specific type of injury, located in the posterior horn of the medial meniscus. The purpose of the study was to evaluate the complications for meniscal ramp lesions left in situ during ACL reconstruction, after more than 20 months of follow up. Methods: All patients who underwent arthroscopic ACLR between January 1998 and December 2000 were evaluated retrospectively. Surgery was performed by the same surgeon. In case of a stable vertical tear, i.e. without instability, the lesion was left in situ, without suture or debridement. The following parameters were examined: demographics; history and clinical findings including time between injury and surgery, side-to-side laxity, pivot shift; knee function and activity by Lysholm score, subjective IKDC, KOOS and Tegner activity scale; and progression to bucket handle. We established two groups: the bucket handle group versus the no bucket handle group. Results: A total of 716 patients underwent a primary ACLR during this period. The overall incidence of ramp lesions in the study population was 5.4% (39 ramp lesions in 716 patients). Mean follow-up time was 262.1 (± 10.5) months. Bucket handle tear of the medial meniscus occurs in 21.4% of our population, with an average lead time of 99 (± 50) months, and a concentration of injuries between 96 and 156 months. The postoperative scores significantly improved for the entire population at more than 20 years of follow-up (p <0.0001), except for the Tegner score (p = 0.3424). Functional scores and side-to-side laxity were the same for the two groups. No risk factors were identified. Conclusion: There is a high incidence of bucket-handle injury after ACL surgery with a residual ramp lesion (21.4%). This high rate is only found in series with a long follow-up, since these lesions appear between 8 and 12 years after the first surgery.
Estimation of the carbon footprint of arthroscopic rotator cuff repair in France
Authors: Rougereau Gregoire , Chatelain Léonard , Conso Christel , Zadegan Frédéric 
Published: March 2022

Objectives: Global warming is certainly one of the greatest challenges of the century. The objective of this work is to estimate the carbon footprint of arthroscopic rotator cuff repair, and to evaluate the positive impact of the following actions: ambulatory surgery, performed under loco-regional anesthesia, and filtration of surgical fluids. Methods: The assessment protocol was compliant with the Greenhouse Gas Protocol, which has three components: 1/ use of volatile anesthetic agents; 2/ electric consumption related to the procedure (heating and air conditioning, ventilation, computer); 3/ related to patient and staff travel, implant delivery and waste management. The study covered the period from November 2020 to April 2021, and included any patient undergoing arthroscopic shoulder replacement surgery. Three actions aimed at improving the carbon footprint were taken: ambulatory surgery, performed under local anesthesia, and filtration of surgical fluids by Neptune® (Stryker). To examine the effectiveness, each patient included during the review period was matched to a patient who underwent surgery during 2018 before the implementation of this protocol. Results: Finally, 26 patients were included. The carbon footprint of arthroscopic rotator cuff repair was estimated at 260.5 +/- 35.03 kgCO2 eq. The main impacts could be attributed to single-use equipment (53.5%), restocking anchors (27.2%), contaminated waste incineration (5.9%), the sterilization process (5.4%), and traveling by the patient (4.1%). Setting up ambulatory surgery without the use of anesthetic gases and a water purifier reduced emissions by 25.9 +/- 2.5 kgCO2 eq (9.3%) per procedure. Conclusion: The carbon footprint of arthroscopic rotary cuff repair corresponds to a bit more than 60 km traveled in a car. The main factor that should be addressed is the impact related to single-use materials and inventory management.
In Vivo Static Retraction and Dynamic Elongation of Rotator Cuff Repair Tissue After Surgical Repair: A Preliminary Analysis at 3 Months
Authors: Lawrence Rebekah L. , Ruder Matthew C. , Zauel Roger , Jalics Alena , Olszewski Adam M. , Diefenbach Brian J. , Moutzouros Vasilios , Makhni Eric C. , Muh Stephanie , Bey Michael J. 
Published: March 2022

Background: Rotator cuff repair is a common orthopaedic procedure that provides pain relief for many patients, but unfortunately, an estimated 20% to 70% of repair procedures will fail. Previous research has shown that elongation (ie, retraction) of a repaired tendon is common even in patients with a repair construct that appears intact on magnetic resonance imaging. However, it is unknown how this repair tissue functions under dynamic conditions. Purpose: To quantify static retraction and maximum dynamic elongation of repair tissue after rotator cuff repair. Study Design: Case series; Level of evidence, 4. Methods: Data from 9 patients were analyzed for this study. During surgery, a 3.1-mm tantalum bead was sutured to the supraspinatus tendon, medial to the repair site. Glenohumeral kinematics were assessed at 1 week (static) and 3 months (static and during scapular-plane abduction) after surgery using a biplanar videoradiographic system. The 3-dimensional position of the bead was calculated relative to the tendon’s insertion on the humerus (ie, bead-to-insertion distance). Static retraction was calculated as the change in the bead-to-insertion distance under static conditions between 1 week and 3 months after surgery, and maximum dynamic elongation was calculated as the maximal positive change in the bead-to-insertion distance during dynamic motion relative to the start of motion. The magnitudes of static retraction and maximum dynamic elongation were assessed with 1-sample t tests. Results: At 3 months after surgery, static retraction occurred in all patients by a mean of 10.0 ± 9.1 mm ( P = .01 compared with no elongation). During scapular-plane abduction, maximum dynamic elongation averaged 1.4 ± 1.0 mm ( P < .01 compared with no elongation). Descriptively, dynamic elongation consistently took 1 of 2 forms: an initial increase in the bead-to-insertion distance (mean, 2.0 ± 0.6 mm) before decreasing until the end of motion or an immediate and substantial decrease in the bead-to-insertion distance at the onset of motion. Conclusion: Repair tissue elongation (static retraction and maximum dynamic elongation) appeared to be a common and significant finding at 3 months after arthroscopic rotator cuff repair. Dynamic elongation of repair tissue during scapular-plane abduction exhibited 1 of 2 distinct patterns, which may suggest different patterns of supraspinatus mechanical and neuromuscular function.
Oral Diseases and Oral Health–Related Quality of Life among Kenyan Children and Adolescents with HIV
Authors: Wang Y. , Ramos-Gomez F. , Kemoli A.M. , John-Stewart G. , Wamalwa D. , Benki-Nugent S. , Slyker J. , Seminario A.L. 
Published: March 2022

Introduction: Children and adolescents living with HIV (CALHIV) have a higher risk of hard and soft oral tissue diseases as compared with their healthy peers. It is important to increase awareness regarding the need to integrate oral health within medical care among pediatric HIV populations. Studies on associations of oral diseases with oral health–related quality of life (OHRQoL) in CALHIV are lacking. This study examined the association between oral diseases and OHRQoL in Kenyan CALHIV. Methods: This cross-sectional analysis was nested in a longitudinal cohort study of CALHIV in Nairobi. CALHIV received oral examinations, and the World Health Organization’s Oral Health Surveys and Record Form was administered. OHRQoL was measured with the Parental-Caregiver Perceptions Questionnaire, with the subdomains of global, oral symptoms, function limitations, and emotional and social well-being, with higher scores indicating poorer OHRQoL. Linear regression was used to model associations between OHRQoL and oral diseases, adjusting for age at the time of oral examination, CD4 counts, and caregiver’s education. Results: Among 71 CALHIV, the mean age was 12.6 y (SD, 2.9; range, 10 to <21), and the mean composite OHRQoL score was 12.6 (SD, 11.2). Ulcers (not herpes simplex virus or aphthous) were associated with the worst overall OHRQoL (mean, 21.8; SD, 11.1; P = 0.055) and oral symptoms subdomain (mean, 7.0, SD, 2.5; P = 0.003). Children with dry mouth and untreated caries had significantly higher mean global OHRQoL scores than those without disease (P < 0.0001). In the multivariate analysis, the OHRQoL composite score was 6.3 units (95% CI, –0.3 to 12.9) higher for those who had dry mouth and untreated dental caries; dry mouth accounted for the highest percentage of variability of OHRQoL (9.6%) and the global subdomain (31.9%). Ulcers accounted for the highest percentage of variability of the oral symptoms domain (15.4%). Conclusions: Oral ulcers, dry mouth, and untreated caries were associated with poorer OHRQoL in CALHIV. Integrating oral health into the primary care of CALHIV may improve their OHRQoL. Knowledge Transfer Statement: This study aimed to determine the association of oral diseases with the oral health–related quality of life of children and adolescents living with HIV (CALHIV). The findings will form part of the evidence to incorporate oral health protocols into care programs for CALHIV. Oral health monitoring has the potential to increase the surveillance of HIV clinical status, monitor the effectiveness of antiretroviral therapy, and improve the oral health–related quality of life of CALHIV.
Optical coherence tomography patterns of diabetic macular edema and treatment response to bevacizumab: a short-term study
Authors: Sharma Sadhana , Karki Pratap , Joshi Sagun Narayan , Parajuli Sanket 
Published: March 2022

Background: The purpose of this study was to evaluate the short-term response of intravitreal bevacizumab in diabetic macular edema (DME) and assess the variation in treatment outcomes in different morphology patterns using spectral domain–optical coherence tomography (SD-OCT). Objective: To study different morphological patterns of DME based on OCT and compare their treatment response to bevacizumab. Methods: Hundred and twelve eyes of 112 patients with DME were included and treated with intravitreal bevacizumab (1.25 mg/0.05 ml monthly for 3 months). The morphological patterns of DME were classified on the basis of OCT into three groups – diffuse retinal thickening (DRT), cystoid macular edema (CME), and serous retinal detachment (SRD) – and changes in central macular thickness (CMT) and best corrected visual acuity (BCVA) after treatment were compared. Results: A total of 112 eyes with DME were included and consisted of 40 DRT, 37 CME, and 35 SRD. Treatment with bevacizumab resulted in decrease in central macular thickness and improvement in BCVA in all three groups. The baseline visual acuity and CMT of DRT group was better than that of the other two groups. The treatment outcome was measured in terms of CMT and BCVA. Change in CMT was statistically significant among three groups and was found to be better in DRT group ( p < 0.05, 95% confidence interval). However, there was statistically no significant variation between the three groups regarding the change in BCVA ( p = 0.169, 95% confidence interval). Conclusion: Anatomic and visual improvement can be achieved by bevacizumab in all patterns of DME. However, individual pattern may respond differently. DRT, which appears to be the earliest form of DME, responds better than other types. Thus, the pattern of macular edema shown by OCT may provide an objective guideline in predicting the response of bevacizumab injection in DME.
Activation of the zinc-sensing receptor GPR39 promotes T-cell reconstitution after hematopoietic cell transplant in mice
Authors: Iovino Lorenzo , Cooper Kirsten , deRoos Paul , Kinsella Sinéad , Evandy Cindy , Ugrai Tamas , Mazziotta Francesco , Ensbey Kathleen S. , Granadier David , Hopwo Kayla , Smith Colton , Gagnon Alex , Galimberti Sara , Petrini Mario , Hill Geoffrey R. , Dudakov Jarrod A. 
Published: March 2022

Abstract
Prolonged lymphopenia represents a major clinical problem after cytoreductive therapies such as chemotherapy and the conditioning required for hematopoietic stem cell transplant (HCT), contributing to the risk of infections and malignant relapse. Restoration of T-cell immunity depends on tissue regeneration in the thymus, the primary site of T-cell development, although the capacity of the thymus to repair itself diminishes over its lifespan. However, although boosting thymic function and T-cell reconstitution is of considerable clinical importance, there are currently no approved therapies for treating lymphopenia. Here we found that zinc (Zn) is critically important for both normal T-cell development and repair after acute damage. Accumulated Zn in thymocytes during development was released into the extracellular milieu after HCT conditioning, where it triggered regeneration by stimulating endothelial cell production of BMP4 via the cell surface receptor GPR39. Dietary supplementation of Zn was sufficient to promote thymic function in a mouse model of allogeneic HCT, including enhancing the number of recent thymic emigrants in circulation although direct targeting of GPR39 with a small molecule agonist enhanced thymic function without the need for prior Zn accumulation in thymocytes. Together, these findings not only define an important pathway underlying tissue regeneration but also offer an innovative preclinical approach to treat lymphopenia in HCT recipients.
Intravenous methylprednisolone pulses in hospitalised patients with severe COVID-19 pneumonia: a double-blind, randomised, placebo-controlled trial
Authors: Salvarani Carlo , Massari Marco , Costantini Massimo , Merlo Domenico Franco , Mariani Gabriella Lucia , Viale Pierluigi , Nava Stefano , Guaraldi Giovanni , Dolci Giovanni , Boni Luca , Savoldi Luisa , Bruzzi Paolo , Turrà Caterina , Catanoso Mariagrazia , Marata Anna Maria , Barbieri Chiara , Valcavi Annamaria , Franzoni Francesca , Cavuto Silvio , Mazzi Giorgio , Corsini Romina , Trapani Fabio , Bartoloni Alessandro , Barisione Emanuela , Barbieri Chiara , Burastero Giulia Jole , Pan Angelo , Inojosa Walter , Scala Raffaele , Burattini Cecilia , Luppi Fabrizio , Codeluppi Mauro , Tarek Kamal Eldin , Cenderello Giovanni , Salio Mario , Foti Giuseppe , Dongilli Roberto , Bajocchi Gianluigi , Negri Emanuele Alberto , Ciusa Giacomo , Fornaro Giacomo , Bassi Ilaria , Zammarchi Lorenzo , Aloè Teresita , Facciolongo Nicola 
Published: March 2022

RationalePulse glucocorticoid therapy is used in hyperinflammation related to coronavirus disease 2019 (COVID-19). We evaluated the efficacy and safety of pulse intravenous methylprednisolone in addition to standard treatment in COVID-19 pneumonia.MethodsIn this multicentre, randomised, double-blind, placebo-controlled trial, 304 hospitalised patients with COVID-19 pneumonia were randomised to receive 1 g of methylprednisolone intravenously for three consecutive days or placebo in addition to standard dexamethasone. The primary outcome was the duration of patient hospitalisation, calculated as the time interval between randomisation and hospital discharge without the need for supplementary oxygen. The key secondary outcomes were survival free from invasive ventilation with orotracheal intubation and overall survival.ResultsOverall, 112 (75.4%) out of 151 patients in the pulse methylprednisolone arm and 111 (75.2%) of 150 in the placebo arm were discharged from hospital without oxygen within 30 days from randomisation. Median time to discharge was similar in both groups (15 days, 95% CI 13.0–17.0 days and 16 days, 95% CI 13.8–18.2 days, respectively; hazard ratio (HR) 0.92, 95% CI 0.71–1.20; p=0.528). No significant differences between pulse methylprednisolone and placebo arms were observed in terms of admission to intensive care unit with orotracheal intubation or death (20.0%versus16.1%; HR 1.26, 95% CI 0.74–2.16; p=0.176) or overall mortality (10.0%versus12.2%; HR 0.83, 95% CI 0.42–1.64; p=0.584). Serious adverse events occurred with similar frequency in the two groups.ConclusionsMethylprenisolone pulse therapy added to dexamethasone was not of benefit in patients with COVID-19 pneumonia.
Cancer risk in severe alpha-1-antitrypsin deficiency
Authors: Hiller Adriana-Maria , Ekström Magnus , Piitulainen Eeva , Lindberg Anne , Rönmark Eva , Tanash Hanan 
Published: March 2022

BackgroundSevere alpha-1-antitrypsin deficiency (AATD), phenotype PiZZ, is a risk factor for pulmonary emphysema and liver disease, but its effect on cancer risk is unknown. Our aim was to evaluate the risk and the risk factors for incident cancer in PiZZ individuals compared with the general population with known smoking habits.MethodsA longitudinal study of PiZZ individuals (n=1595) from the Swedish National AATD Register, and controls (n=5999) from Swedish population-based cohorts. Data on cancer and mortality were obtained by cross-linkage with national registers. Individuals who had undergone lung transplantation (n=10) and those with a cancer diagnosis within 5 years prior to inclusion (n=63) were excluded. The risk factors for developing cancer were analysed using proportional hazards and Fine–Gray regression models, adjusting for age, sex, smoking habits and the presence of liver disease.ResultsThe median follow-up time was 17 years (interquartile range 11 years) for the whole study population. The incidence rates of hepatic and non-hepatic cancer per 1000 person-years were 1.6 (95% CI 1.1–2.3) and 8.5 (95% CI 7.2–10.0), respectively, for the PiZZ individuals, and 0.1 (95% CI 0.04–0.2) and 6.6 (95% CI 6.0–7.1), respectively, for the controls. The adjusted hazard ratios for hepatic and for non-hepatic cancer were 23.4 (95% CI 9.9–55.4) and 1.3 (95% CI 1.1–1.5), respectively, in the PiZZ individuals compared with the controls.ConclusionThese results suggest that individuals with severe AATD may have an increased risk of developing both hepatic and non-hepatic cancer, compared with the general population.