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1.
Braz. j. biol ; 83: e249229, 2023. tab, graf
Artigo em Inglês | LILACS-Express | MEDLINE, LILACSEXPRESS | ID: biblio-1339374

RESUMO

Abstract Birds are very valuable indicators of species richness and endemic patterns in a specified ecosystem, which eventually help the scientist to measure the environmental degradation. The aim of present study was to know human knowledge and attitude toward urban birds in Faisalabad city, Pakistan. The study conducted in four consecutive months: November 2019 to February 2020. Population of birds was noted from eight residential towns of Faisalabad city, data were collected through questionnaire. Faisalabad has a reasonably large population of birds and present data show that, there is a significant difference between favorite bird of residential areas and institutions. The pigeon received the most likeness in bird population among residential area residents, while the myna received the least. The most popular bird in Faisalabad institutions was the sparrow, while the least popular bird was the common myna. Bird adaptation percentage of residential areas and institutional areas of Faisalabad was the highest for parrot and sparrow respectively. People in residential areas and institutions, on the other hand, adapted least to common myna. It is concluded that people of the study area like birds and offered food and high population of birds are present in study area.


Resumo Os pássaros são indicadores muito valiosos da riqueza de espécies e padrões endêmicos em um determinado ecossistema, o que acaba ajudando o cientista a medir a degradação ambiental. O objetivo do presente estudo foi conhecer o conhecimento humano e a atitude em relação às aves urbanas na cidade de Faisalabad, Paquistão. O estudo foi conduzido em quatro meses consecutivos: novembro de 2019 a fevereiro de 2020. A população de pássaros foi observada em oito cidades residenciais da cidade de Faisalabad, os dados foram coletados por meio de questionário. Faisalabad tem uma população razoavelmente grande de pássaros, e os dados atuais mostram que há uma diferença significativa entre as aves favoritas de áreas residenciais e instituições. O pombo recebeu mais semelhanças na população de pássaros entre os residentes de áreas residenciais, enquanto o myna recebeu menos. A ave mais popular nas instituições de Faisalabad era o pardal, enquanto a ave menos popular era o myna comum. A porcentagem de adaptação de pássaros em áreas residenciais e institucionais de Faisalabad foi a mais alta para papagaios e pardais, respectivamente. As pessoas em áreas residenciais e instituições, por outro lado, se adaptaram menos ao myna comum. Conclui-se que pessoas da área de estudo como pássaros e alimentos oferecidos e alta população de pássaros estão presentes na área de estudo.

2.
BMC Med Educ ; 22(1): 18, 2022 Jan 06.
Artigo em Inglês | MEDLINE | ID: mdl-34991556

RESUMO

BACKGROUND: The United States opioid epidemic is a devastating public health crisis fueled in part by physician prescribing. While the next generation of prescribers is crucial to the trajectory of the epidemic, medical school curricula designated to prepare students for opioid prescribing (OP) and pain management is often underdeveloped. In response to this deficit, we aimed to investigate the impact of an online opioid and pain management (OPM) educational intervention on fourth-year medical student knowledge, attitudes, and perceived competence. METHODS: Graduating students completing their final year of medical education at Sidney Kimmel Medical College of Thomas Jefferson University were sent an e-mail invitation to complete a virtual OPM module. The module consisted of eight interactive patient cases that introduced topics through a case-based learning system, challenging students to make decisions and answer knowledge questions about the patient care process. An identical pre- and posttest were built into the module to measure general and case-specific learning objectives, with responses subsequently analyzed using the Wilcoxon matched-pairs signed-rank test. RESULTS: Forty-three students (19% response rate) completed the module. All median posttest responses ranked significantly higher than paired median pretest responses (p <  0.05). Comparing the paired overall student baseline score to module completion, median posttest ranks (Mdn = 206, IQR = 25) were significantly higher than median pretest ranks (Mdn = 150, IQR = 24) (p <  0.001). Regarding paired median Perceived Competence Scale metrics specifically, perceived student confidence, capability, and ability in opioid management increased from "disagree" (2) to "agree" (4) (p <  0.001), and student ability to meet the challenge of opioid management increased from "neither agree nor disagree" (3) to "agree" (4) (p <  0.001). Additionally, while 77% of students reported receiving OP training in medical school, 21% reported no history of prior training. CONCLUSION: Implementation of a virtual, interactive module with clinical context is an effective framework for improving the OPM knowledge, attitudes, and perceived competence of fourth-year medical students. This type of intervention may be an important method for standardizing and augmenting the education of future prescribers across multiple institutions.


Assuntos
Analgésicos Opioides , Estudantes de Medicina , Analgésicos Opioides/uso terapêutico , Currículo , Humanos , Manejo da Dor , Padrões de Prática Médica
3.
J Hand Surg Am ; 2022 Jan 07.
Artigo em Inglês | MEDLINE | ID: mdl-35012796

RESUMO

PURPOSE: The purpose of this study was to evaluate the efficacy of a video versus that of a paper handout for explaining operative instructions for hand and upper extremity surgeries to patients. We aimed to compare patient performance using a knowledge-based questionnaire. In addition, we aimed to compare how helpful patients found their assigned operative instructions. METHODS: This was a randomized trial of 60 patients undergoing same-day hand and upper extremity surgeries. The patients were randomized to receive educational material outlining operative instructions, either in the form of a video link or a paper handout. At the first postoperative visit, the patients' comprehension of the content was evaluated using a questionnaire. The primary outcomes included the number of questions answered correctly and patient-reported evaluation of the provided instructions on a scale of 1-5. RESULTS: Patients who received video instructions scored higher in the questionnaire than those in the paper instructions group (paper: 58% correct; video: 76% correct). Moreover, patients in the video group were significantly more likely to answer questions pertaining to opioid use correctly. A higher proportion of patients in the video group than in the paper group found the information "extremely" or "very" helpful. CONCLUSIONS: This study found that the patients demonstrated greater comprehension of the operative instructions when these were administered in a video format than when these were administered as a printed handout. In particular, the results suggest that video-based education specifically improves patients' comprehension of proper opioid use. CLINICAL RELEVANCE: There appears to be utility in implementing videos for patient education purposes, particularly in the setting of operative instructions for same-day surgical procedures.

4.
Orthopedics ; : 1-6, 2022 Jan 12.
Artigo em Inglês | MEDLINE | ID: mdl-35021026

RESUMO

Literature on adverse events (AEs) after outpatient orthopedic surgery is relatively sparse, and efforts to detect, measure, and track AEs after outpatient surgery lag behind those for the inpatient setting. Detection of AEs has traditionally relied on patient safety indicators (from billing data) and self-reporting, but these methods have been shown to have low sensitivity, missing up to 90% of AEs. There is growing recognition that the trigger method, which uses "triggers" as red flags to initiate more detailed chart audits, can serve as a more sensitive alternative to detect AEs. Moreover, the recent widespread adoption of electronic health records (EHRs) can provide faster automated methods for identifying triggers and estimating AE rates. This study evaluates the ability of 6 separate EHR-based triggers to predict AEs after outpatient orthopedic surgery and compares this trigger method with AE self-reporting. Triggers have the potential to decrease postoperative morbidity after out-patient orthopedic surgery and may lead to quality improvement. Further research is needed to qualify triggers as screening tools in the outpatient setting. [Orthopedics. 20XX;XX(X):xx-xx.].

5.
J Wrist Surg ; 10(6): 528-532, 2021 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-34881109

RESUMO

Background Due to limited sensitivity of radiographs for scaphotrapeziotrapezoid (STT) arthritis and the high rate of concurrence between thumb carpometacarpal (CMC) and STT arthritis, intraoperative visualization of the STT joint is recommended during CMC arthroplasty. Purpose We quantified the percentage of trapezoid facet of the scaphotrapezoid (ST) joint that could be visualized during this approach, and compared it to the degree of preoperative radiographic STT arthritis. Methods We performed dorsal surgical approach to the thumb CMC joint after obtaining fluoroscopic anteroposterior, lateral, and oblique wrist radiographs of 11 cadaver wrists. After trapeziectomy, the ST joint was inspected and the visualized portion of the trapezoid articulation marked with an electrocautery. The trapezoid was removed, photographed, and the marked articular surface area and total surface area were independently measured by two authors using an image analysis software. The radiographs were analyzed for the presence of STT arthritis. Results The mean visualized trapezoid surface area during standard approach for CMC arthroplasty was 60.3% (standard deviation: 24.6%). The visualized percentage ranged widely from 16.7 to 96.5%. There was no significant correlation between degree of radiographic arthritis and visualized percentage of the joint ( p = 0.77). Conclusions: On average, 60% of the trapezoid joint surface was visualized during routine approach to the thumb CMC joint, but with very large variability. Direct visualization of the joint did not correlate with the degree of radiographic STT arthritis. Clinical Relevance A combination of clinical examination, pre- and intraoperative radiographs, and intraoperative visualization should be utilized to assess for STT osteoarthritis and determine the need for surgical treatment. Level of Evidence This is a Cadaveric Research Article.

6.
Braz J Biol ; 83: e249229, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34669801

RESUMO

Birds are very valuable indicators of species richness and endemic patterns in a specified ecosystem, which eventually help the scientist to measure the environmental degradation. The aim of present study was to know human knowledge and attitude toward urban birds in Faisalabad city, Pakistan. The study conducted in four consecutive months: November 2019 to February 2020. Population of birds was noted from eight residential towns of Faisalabad city, data were collected through questionnaire. Faisalabad has a reasonably large population of birds and present data show that, there is a significant difference between favorite bird of residential areas and institutions. The pigeon received the most likeness in bird population among residential area residents, while the myna received the least. The most popular bird in Faisalabad institutions was the sparrow, while the least popular bird was the common myna. Bird adaptation percentage of residential areas and institutional areas of Faisalabad was the highest for parrot and sparrow respectively. People in residential areas and institutions, on the other hand, adapted least to common myna. It is concluded that people of the study area like birds and offered food and high population of birds are present in study area.


Assuntos
Aves , Ecossistema , Animais , Biodiversidade , Cidades , Humanos , Paquistão
7.
BMC Genomics ; 22(Suppl 3): 700, 2021 Sep 28.
Artigo em Inglês | MEDLINE | ID: mdl-34583643

RESUMO

BACKGROUND: Biology has entered the era of big data with the advent of high-throughput omics technologies. Biological databases provide public access to petabytes of data and information facilitating knowledge discovery. Over the years, sequence data of pathogens has seen a large increase in the number of records, given the relatively small genome size and their important role as infectious and symbiotic agents. Humans are host to numerous pathogenic diseases, such as that by viruses, many of which are responsible for high mortality and morbidity. The interaction between pathogens and humans over the evolutionary history has resulted in sharing of sequences, with important biological and evolutionary implications. RESULTS: This study describes a large-scale, systematic bioinformatics approach for identification and characterization of shared sequences between the host and pathogen. An application of the approach is demonstrated through identification and characterization of the Flaviviridae-human share-ome. A total of 2430 nonamers represented the Flaviviridae-human share-ome with 100% identity. Although the share-ome represented a small fraction of the repertoire of Flaviviridae (~ 0.12%) and human (~ 0.013%) non-redundant nonamers, the 2430 shared nonamers mapped to 16,946 Flaviviridae and 7506 human non-redundant protein sequences. The shared nonamer sequences mapped to 125 species of Flaviviridae, including several with unclassified genus. The majority (~ 68%) of the shared sequences mapped to Hepacivirus C species; West Nile, dengue and Zika viruses of the Flavivirus genus accounted for ~ 11%, ~ 7%, and ~ 3%, respectively, of the Flaviviridae protein sequences (16,946) mapped by the share-ome. Further characterization of the share-ome provided important structural-functional insights to Flaviviridae-human interactions. CONCLUSION: Mapping of the host-pathogen share-ome has important implications for the design of vaccines and drugs, diagnostics, disease surveillance and the discovery of unknown, potential host-pathogen interactions. The generic workflow presented herein is potentially applicable to a variety of pathogens, such as of viral, bacterial or parasitic origin.


Assuntos
Flaviviridae , Infecção por Zika virus , Zika virus , Biologia Computacional , Hepacivirus , Humanos , Filogenia , Zika virus/genética
8.
J Hand Microsurg ; 13(3): 189-195, 2021 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-34511838

RESUMO

Introduction Heterotopic ossification (HO) can be a potentially serious and devastating complication following traumatic injury to the elbow. HO prophylaxis options include nonsteroidal anti-inflammatory drugs (NSAIDs) and radiation therapy (RT) but neither has been proven more effective. The purpose of this review is to compare effectiveness and outcomes between NSAID and RT prophylaxis for HO about the elbow following a traumatic injury. Materials and Methods We performed a systematic review of PubMed and Cochrane Library for cases of HO prophylaxis following elbow trauma utilizing PRISMA guidelines to determine the most effective form of prophylaxis. Outcomes of interest included recurrence of HO, range of motion (ROM), and Mayo elbow performance index (MEPI). A total of 36 articles and 826 elbows of which 203 received RT and 623 received NSAID were identified and included in the final analysis. Results Rates of HO formation or recurrence following elbow trauma were similar between radiation and NSAID prophylaxis (15.6% vs. 22.2%, respectively p = 0.457). ROM was similar in flexion and extension arc (109.0 degrees in radiation vs. 112.8 in NSAIDs, p = 0.459) and in pronation and supination arc (118.9 degrees radiation vs. 134.7 degrees NSAIDs, p = 0.322). MEPI scores were 79.19 in the radiation group and 88.82 in the NSAIDs group at the final follow-up. Conclusion There is no statistical difference in HO development, recurrence, or final ROM between NSAIDs and RT prophylaxis following trauma to the elbow. We recommend the choice of modality based on patient characteristics, cost, and surgeon preference. Level of Evidence Level III.

9.
Biology (Basel) ; 10(9)2021 Aug 31.
Artigo em Inglês | MEDLINE | ID: mdl-34571730

RESUMO

The study of viral diversity is imperative in understanding sequence change and its implications for intervention strategies. The widely used alignment-dependent approaches to study viral diversity are limited in their utility as sequence dissimilarity increases, particularly when expanded to the genus or higher ranks of viral species lineage. Herein, we present an alignment-independent algorithm, implemented as a tool, UNIQmin, to determine the effective viral sequence diversity at any rank of the viral taxonomy lineage. This is done by performing an exhaustive search to generate the minimal set of sequences for a given viral non-redundant sequence dataset. The minimal set is comprised of the smallest possible number of unique sequences required to capture the diversity inherent in the complete set of overlapping k-mers encoded by all the unique sequences in the given dataset. Such dataset compression is possible through the removal of unique sequences, whose entire repertoire of overlapping k-mers can be represented by other sequences, thus rendering them redundant to the collective pool of sequence diversity. A significant reduction, namely ~44%, ~45%, and ~53%, was observed for all reported unique sequences of species Dengue virus, genus Flavivirus, and family Flaviviridae, respectively, while still capturing the entire repertoire of nonamer (9-mer) viral peptidome diversity present in the initial input dataset. The algorithm is scalable for big data as it was applied to ~2.2 million non-redundant sequences of all reported viruses. UNIQmin is open source and publicly available on GitHub. The concept of a minimal set is generic and, thus, potentially applicable to other pathogenic microorganisms of non-viral origin, such as bacteria.

10.
Saudi J Biol Sci ; 28(10): 5526-5537, 2021 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-34588862

RESUMO

Superoxide Dismutase SODs are defense associated proteins that detoxify ROS and primarily serve as scavengers. They have been described in numerous plant species, but their in-depth characterization in Brassica rapa has not been reported. Therefore, the present investigation on genome wide study of SOD gene family was conducted to identify BrSOD genes, their domain-based organization, gene structure analysis, phylogenetic analysis, intron-exon structure of genes and expression analysis. The sequence characterization of Super oxide dismutase gene family in Brassica rapa, their syntenic associateship of conserved motifs and phylogenetic correlationship, prediction of cis-elements and determing the expression analysis in distinct tissues namely plant callus, root, stem, leaf, flower, and silique under abiotic conditions have been analysed using different software's. The study on SOD gene family identified 17 BrSOD genes which were grouped into eight BrCu-ZnSODs and nine BrFe-MnSODs domain-based organization. Furthermore, the conserved character of BrSODs were confirmed by intron-exon organisation, motif arrangements and domain architectural investigations. Expression analysis using RNA Sequence data of different developmental stages proclaimed that genes were manifested in all six tissues with an exception of BrCu-ZnSOD3, which was not manifested in roots; however, whose transcript was detected in all other tested tissues. The study has genome wide insight into the occurrence and functional specifications of BrSOD gene family in Brassica rapa that can be potentially utilized in breeding program for resilience to climate change and abiotic stresses tolerance Brassica variety.

11.
Indian J Occup Environ Med ; 25(2): 106-110, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34421247

RESUMO

Background: Flexible foam industry largely uses 2,4 and 2,6 Toluene di-isocyanate as main raw materials and chronic exposure to its result in occupational asthma. The exposure to di-isocyanates might be higher due to the usage of obsolete technology, hand-mixing methods and working in confined spaces with insufficient local exhaust ventilation systems in developing countries. Exposure studies in flexible foam industries have not been done in developing countries. Objective: The present cross-sectional study was conducted to evaluate toluene di-isocyanate (TDI) exposures and respiratory health of the workers working in the seven flexible polyurethane foam industries located in Western India during 2010-2013. Method: A total of 128 personal air samples collected and evaluated for total TDI concentration using improved Occupational Safety and Head Administration method number 42. Then 194 workers were covered for complete clinical examination and spirometry for assessing respiratory health. Results: In all, 17.83% of air samples exceeded the ACGIH TWA-TLV of 0.005 ppm for TDI. Though only 11 (5.6%) workers had respiratory complaints, the spirometry revealed that 19 (9.8%) and four (2.1%) had restrictive and obstructive type of pulmonary function impairment, respectively. Conclusion: The TWA concentration of TDI exceeded at raw material storage, mixing, foaming, block cutting and curing areas in four out of seven industries even in the presence of local exhaust systems. The respiratory health effect is less when compared to exposure to TDI, suitable preventive and control measures were suggested based on the study findings to the stakeholders to prevent the increase of respiratory health effects.

12.
Pol J Vet Sci ; 24(2): 281-286, 2021 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-34250781

RESUMO

Spleen is highly vascularized organ and bleeding control during partial splenectomy is a big challenge. In this study conventional methods of electrocautery, absorbable suturing and advance methods of topical hemostat Surgicel® were compared to control bleeding during partial splenec- tomy. Twelve healthy dogs (n=4) were divided in A, B and C groups. After partial splenectomy Surgicel®, electrocautery and absorbable horizontal mattress sutures were used to control hemor- rhages in group A, B and C respectively. Bleeding time and loss of blood volume was evaluated during surgery. In addition, blood samples were taken on day 0 pre-surgery and on days 3, 10 and 17 post-surgery to evaluate changes in biochemical parameters after the application of dif- ferent hemostatic techniques. Ultrasonography was also performed at alternative days to check any gross changes in the spleen. Dogs in group A showed minimum bleeding time and loss of blood volume as compared to group B and C. Drop in red blood cells count was compared be- tween group A, B and C showing significant change (p≤0.05) at day 3, 10 and 17, while a sig- nificant decline in hemoglobin was found in group C followed by groups B and A at 3rd and 10th day. There was no difference between platelet counts in various groups. Ultrasonography showed no significant changes in the spleen parenchyma. It was concluded that Surgicel® was an effective material for controlling hemorrhage in veterinary patients.


Assuntos
Perda Sanguínea Cirúrgica/veterinária , Celulose Oxidada/farmacologia , Hemostasia Cirúrgica/veterinária , Baço/cirurgia , Esplenectomia/veterinária , Animais , Perda Sanguínea Cirúrgica/prevenção & controle , Celulose Oxidada/administração & dosagem , Doenças do Cão , Cães , Hemostasia Cirúrgica/métodos , Hemostáticos/administração & dosagem , Hemostáticos/farmacologia , Esplenectomia/métodos
13.
Plant Biol (Stuttg) ; 23(6): 1027-1036, 2021 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-34263982

RESUMO

Bacteria secrete lipopeptide (surfactin) molecules, which are known to act as natural antibiotics. Recently, research on lipopeptide molecules has grown because of their role in increasing resistance to plant pathogens. Isolated surfactin molecules at several concentrations, viz. 35, 25, 15 and 5 ppm, were used in an in vitro study for analysis of egg hatching inhibition and second-stage juvenile (J2) mortality of the nematode Meloidogyne incognita. Cell suspensions (1.2 × 108  cfu·ml-1 ) of both Bacillus subtilis (MTCC-441) and Pseudomonas putida (MTCC-102) were used in J2 inoculated tomato plants. Root-dip treatment of tomato seedlings with the crude lipopeptide (35 ppm) was also performed to analyse biocontrol potential. MALDI-TOF MS analysis was conducted to determine specific lipopeptide molecules. Data showed nematode egg mortality of 85% in the 35 ppm surfactin concentration 96 h after exposure. The maximum ovicidal activity was 83.97% after incubation with 35 ppm surfactin for the same exposure period. Plant growth attributes and biochemical parameters were significantly improved when bacterial cultures were applied before J2 inoculation of tomato seedlings. We also recorded a reduction in egg masses, nematode population and root galling. The J2 penetration into tomato roots was effective in the root-dip experiments. Surfactin mass peak was determined at m/z 1058 [M+Na]+ using MALDI-TOF MS. These results indicate that bacterial cell suspensions can be used as a potent and versatile source to deal with nematode infection and provide a rich source of bioactive compounds with antinematode activity.


Assuntos
Lycopersicon esculentum , Tylenchoidea , Animais , Antinematódeos/farmacologia , Bacillus subtilis
14.
Orthopedics ; 44(4): e620-e625, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34292828

RESUMO

Distal radius fractures are among the most commonly encountered injuries treated by orthopedic surgeons. The incidence of distal radius fractures appears to be on the rise. Although this injury is usually treated nonoperatively, surgical management is often indicated and involves several options, including percutaneous pinning, fragment-specific fixation, volar/dorsal/radial locked plating, intramedullary fixation, and external fixation. More recently, dorsal spanning bridge plating has been introduced for certain fracture patterns and patient circumstances. This article reviews the indications, surgical techniques, outcomes, and potential complications associated with bridge plating of distal radius fractures. The authors believe that this article will familiarize surgeons with an additional surgical technique that can be used to treat complex presentations of a common orthopedic injury. [Orthopedics. 2021;44(4):e620-e625.].


Assuntos
Fraturas do Rádio , Cirurgiões , Placas Ósseas , Fixação Interna de Fraturas , Humanos , Rádio (Anatomia) , Fraturas do Rádio/diagnóstico por imagem , Fraturas do Rádio/cirurgia
15.
Orthopedics ; 44(4): e487-e492, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34292830

RESUMO

The goal of this study was to determine the relationship of digital artery pressure to arm position and forearm skin surface pressure using a short-arm cast experimental setup, to ascertain the safest position for the injured casted upper extremity. A total of 27 volunteers were placed in bilateral short-arm fiber-glass casts with an empty 50-mL bladder bag under the cast and attached to a pressure transducer. Digital systolic pressure (Pdig), and skin surface pressure under the cast (Pskin) were assessed in 4 positions. Measurements were taken with and without 50 mL air in the bladder bag. A total of 54 forearms were evaluated. Both arm position and Pskin had a significant effect on Pdig (P<.001 for both), with increasing elevation leading to a decrease in Pdig (r=-0.50). The effect size of position on Pdig was large, whereas that of Pskin was small (partial eta-squared=0.371 and 0.028, respectively). Linear regression analysis of Pskin and Pdig with air in the neutral position yielded a moderate negative relationship with body mass index (r=-0.64, P<.001 for Pskin; r=0.49, P<.001 for Pdig) and wrist circumference (r=-0.66, P<.001 for Pskin; r=0.52, P<.001 for Pdig), without significant association with forearm length. For volunteers with short-arm fiberglass casts, increasing arm elevation had a large effect size on digital arterial pressure, whereas 50 mL simulated swelling had only a small effect size. Decreasing body mass index and forearm circumference correlated with increased skin surface pressure and decreased digital arterial pressure. These findings show that aggressive elevation of the injured limb may not be as desirable as previously believed. [Orthopedics. 2021;44(4):e487-e492.].


Assuntos
Moldes Cirúrgicos , Extremidade Superior , Vidro , Humanos , Perfusão , Pressão
16.
J Wrist Surg ; 10(3): 255-261, 2021 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-34109071

RESUMO

Background Headless compression screw fixation with bone grafting has been the mainstay of treatment for scaphoid nonunion for the past several decades. Recently, locked volar plate fixation has gained popularity as a technique for scaphoid fixation, especially for recalcitrant or secondary nonunions. Purpose The purpose of this meta-analysis was to compare union rates and clinical outcomes between locked volar plate fixation and headless compression screw fixation for the treatment of scaphoid nonunions. Methods A literature search was performed for studies documenting treatment outcomes for scaphoid nonunions from 2000 to 2020. Inclusion criteria consisted of (1) average age > 18 years, (2) primary study using screw fixation, plate fixation, or both, with discrete data reported for each procedure, and (3) average follow-up of at least 3 months. Exclusion criteria consisted of studies with incomplete or missing data on union rates. Data from each study was weighted, combined within treatment groups, and compared across treatment groups using a generalized linear model or binomial distribution. Results Following title and full-text review, 23 articles were included for analysis. Preoperatively, patients treated with plate fixation had significantly longer time from injury to surgery and were more likely to have failed prior surgical intervention. There was no significant difference between union rates at 92 and 94% for screw and plate fixation, respectively. However, plate fixation resulted in longer time to union and lower modified Mayo wrist scores. Conclusion Patients treated with locked volar plate fixation were more likely to be used for recalcitrant or secondary nonunions. There was no statistically significant difference in union rates between screw and plate fixation. The results from this meta-analysis support the select use of locked volar plate fixation for scaphoid nonunion, especially recalcitrant nonunions and those that have failed prior surgical repair.

17.
Viruses ; 13(5)2021 05 10.
Artigo em Inglês | MEDLINE | ID: mdl-34068495

RESUMO

Avian influenza virus A (H7N9), after circulating in avian hosts for decades, was identified as a human pathogen in 2013. Herein, amino acid substitutions possibly essential for human adaptation were identified by comparing the 4706 aligned overlapping nonamer position sequences (1-9, 2-10, etc.) of the reported 2014 and 2017 avian and human H7N9 datasets. The initial set of virus sequences (as of year 2014) exhibited a total of 109 avian-to-human (A2H) signature amino acid substitutions. Each represented the most prevalent substitution at a given avian virus nonamer position that was selectively adapted as the corresponding index (most prevalent sequence) of the human viruses. The majority of these avian substitutions were long-standing in the evolution of H7N9, and only 17 were first detected in 2013 as possibly essential for the initial human adaptation. Strikingly, continued evolution of the avian H7N9 virus has resulted in avian and human protein sequences that are almost identical. This rapid and continued adaptation of the avian H7N9 virus to the human host, with near identity of the avian and human viruses, is associated with increased human infection and a predicted greater risk of human-to-human transmission.


Assuntos
Adaptação Biológica , Interações Hospedeiro-Patógeno , Subtipo H7N9 do Vírus da Influenza A/fisiologia , Influenza Aviária/virologia , Influenza Humana/virologia , Infecções por Orthomyxoviridae/virologia , Substituição de Aminoácidos , Animais , Aves , Variação Genética , Humanos , RNA Viral , Especificidade da Espécie
18.
J Am Acad Orthop Surg ; 29(15): 648-658, 2021 Aug 01.
Artigo em Inglês | MEDLINE | ID: mdl-34037556

RESUMO

Injuries of the hand and wrist are common in baseball. Because of the unique motions and loads encountered in this sport, physicians treating baseball players may encounter hand and wrist injuries ranging from common to rare. An understanding of these baseball-related injuries must include their pathoanatomy, diagnosis, and treatment options. This knowledge is critical for the general orthopaedic surgeon treating baseball players to allow for timely and appropriate treatment. This article reviews the pathophysiology, diagnosis, and treatment of baseball-related hand and wrist injuries, with a target audience of general orthopeadic surgeons.


Assuntos
Traumatismos em Atletas , Beisebol , Traumatismos do Punho , Traumatismos em Atletas/diagnóstico , Traumatismos em Atletas/epidemiologia , Traumatismos em Atletas/terapia , Mãos , Humanos , Punho , Traumatismos do Punho/diagnóstico , Traumatismos do Punho/etiologia , Traumatismos do Punho/terapia , Articulação do Punho
19.
Hand (N Y) ; : 1558944721994227, 2021 Mar 31.
Artigo em Inglês | MEDLINE | ID: mdl-33789518

RESUMO

BACKGROUND: Thumb carpometacarpal (CMC) joint arthroplasty is a common procedure in the surgical management of symptomatic thumb basal joint arthritis. Following trapeziectomy, a number of suspensionplasty techniques are often used, but limited comparative evidence exists between these techniques. The central aim of this study was to prospectively compare the outcomes of 2 suspensionplasty techniques following trapeziectomy: suture button (TightRope) versus ligament reconstruction and tendon interposition (LRTI). METHODS: Prospective data were collected on 112 consecutive patients with Eaton stage III-IV thumb CMC arthritis who underwent open trapeziectomy and suspensionplasty. There were 53 LRTI and 59 TightRope suspensionplasty procedures. Outcomes were measured using the Quick Disabilities of the Arm, Shoulder, and Hand (QuickDASH) questionnaire, Visual Analogue Scale (VAS) for pain, radiographic analysis, and lateral pinch strength. Patient demographic data and complications were also recorded. RESULTS: Patients undergoing TightRope suspensionplasty had significantly higher trapeziometacarpal index and thus less subsidence than the LRTI group at 2 weeks (0.22 vs 0.17 [P < .0001]) and 3 months (0.17 vs 0.15 [P < .05]) postoperatively. TightRope suspensionplasty also had a significantly lower QuickDASH score at 2 weeks (64.7 vs 74.6 [P < .05]), 3 months (20.7 vs 32.5 [P < .05]), and 1 year postoperatively (7.57 vs 21.5 [P < .05]) compared with the LRTI group. However, there was no difference in VAS pain, lateral pinch strength, reoperation, or complications at any time point between groups. CONCLUSIONS: Thumb CMC joint arthroplasty performed with a TightRope suspensionplasty versus LRTI yielded short-term improved resistance to subsidence, long-term greater improvement in clinical outcome by QuickDASH, and no difference in pain or complication rates.

20.
Hand Clin ; 37(2): 259-266, 2021 05.
Artigo em Inglês | MEDLINE | ID: mdl-33892879

RESUMO

There are several options for plate fixation of distal radius fractures. Volar plating has broad applicability and consistent outcomes, and thus is the most commonly used plate type. Dorsal plates are advantageous for specific fracture patterns, and can provide direct fracture reduction and buttressing, but may be prominent and can cause tendon irritation. Bridge plates offer an alternative to external fixation while avoiding the complications with prominent hardware, because they span highly comminuted fractures and can be used for immediate weight bearing; however, they require plate removal. Choice of plate fixation should depend on fracture type, patient factors, and surgeon experience.


Assuntos
Fraturas Cominutivas , Fraturas do Rádio , Placas Ósseas , Fixação Interna de Fraturas , Fraturas Cominutivas/cirurgia , Humanos , Fraturas do Rádio/cirurgia , Resultado do Tratamento
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