RESUMEN
BACKGROUND: Patients with psoriasis are at risk of a co-morbid diagnosis of depression and/or anxiety. It is therefore essential for dermatologists to have valid and effective instruments that can screen and monitor depression and anxiety symptoms in psoriasis patients. OBJECTIVE: The aim of this study was to validate the Mental Health Inventory (MHI-5) as a brief measure that can be used to evaluate psychological distress related to anxiety and depression in psoriasis patients. METHODS: The sample included 76 adult dermatological outpatients diagnosed with psoriasis. Participants completed the MHI-5, the Hospital Anxiety and Depression Scale (HADS) and six subscales of the Self-Compassion Scale (SCS). Confirmatory factor analysis (CFA) was applied to examine the factor structure of MHI-5. Convergent validity was examined by applying correlations among all measures. Discriminant validity was examined by applying hierarchical regression models. Reliability was examined by calculating Cronbach's alpha coefficient. RESULTS: Confirmatory factor analysis showed that the proposed one-factor model has a good fit to the data. The MHI-5 demonstrated satisfactory convergent validity by yielding significant moderate to strong correlations with the HADS and with the positive and negative subscales of the SCS. Discriminant validity was also evident with being at risk of anxiety predicting MHI-5 scores above and beyond the effect of gender and age. Hierarchical regressions were not performed because a very small number of participants (n = 3) were classified at risk of depression. The MHI-5 showed high internal consistency (α = 0.84). CONCLUSION: This investigation provided evidence that MHI-5 is a reliable and valid instrument that can be used to effectively capture psychological distress in psoriasis patients.
Asunto(s)
Ansiedad/diagnóstico , Depresión/diagnóstico , Psoriasis/psicología , Distrés Psicológico , Encuestas y Cuestionarios , Adolescente , Adulto , Anciano , Ansiedad/etiología , Depresión/etiología , Análisis Factorial , Femenino , Humanos , Masculino , Tamizaje Masivo , Persona de Mediana Edad , Escalas de Valoración Psiquiátrica , Psicometría , Reproducibilidad de los Resultados , Adulto JovenAsunto(s)
Infecciones por Coronavirus/epidemiología , Planificación en Salud , Pandemias , Neumonía Viral/epidemiología , Betacoronavirus , COVID-19 , Infecciones por Coronavirus/economía , Infecciones por Coronavirus/psicología , Infecciones por Coronavirus/rehabilitación , Fatiga/virología , Humanos , Debilidad Muscular/virología , Pandemias/economía , Neumonía Viral/economía , Neumonía Viral/psicología , Neumonía Viral/rehabilitación , Distrés Psicológico , Síndrome de Dificultad Respiratoria/virología , SARS-CoV-2 , Poblaciones VulnerablesRESUMEN
The level of bone resection for osteosarcoma depends on the pre-operative evaluation of the extent of intramedullary tumour. We compared the accuracy of magnetic resonance imaging (MRI), computerised tomography (CT), and isotope bone scanning with the actual extent of the tumour in the resected specimens from 34 patients with primary osteosarcoma of a long bone. The extent of medullary tumour was defined accurately in 23 of 24 MRI scans (96%) and 24 of 32 CT scans (75%). A flexion contracture of a joint close to the tumour was an important cause for inaccurate measurements from both MRI and CT scans. Isotope bone scanning was inaccurate: its role is now confined to detecting skeletal metastases and skip lesions.
Asunto(s)
Médula Ósea/patología , Neoplasias Óseas/diagnóstico , Osteosarcoma/diagnóstico , Adolescente , Adulto , Médula Ósea/diagnóstico por imagen , Neoplasias Óseas/diagnóstico por imagen , Niño , Femenino , Humanos , Imagen por Resonancia Magnética , Masculino , Persona de Mediana Edad , Osteosarcoma/diagnóstico por imagen , Cintigrafía , Tomografía Computarizada por Rayos XRESUMEN
A hematoma in the midpalmar space following a crush injury produced the signs and symptoms of compartment syndrome. The clinical presentation, findings at surgery, and likely pathogenesis are discussed.
Asunto(s)
Síndromes Compartimentales/diagnóstico , Fracturas Cerradas/diagnóstico , Traumatismos de la Mano/diagnóstico , Hematoma/diagnóstico , Metacarpo/lesiones , Accidentes de Trabajo , Adulto , Hilos Ortopédicos , Síndromes Compartimentales/diagnóstico por imagen , Diagnóstico Diferencial , Estudios de Seguimiento , Fijación de Fractura/instrumentación , Fijación de Fractura/métodos , Curación de Fractura/fisiología , Fracturas Cerradas/diagnóstico por imagen , Fracturas Cerradas/cirugía , Traumatismos de la Mano/diagnóstico por imagen , Traumatismos de la Mano/cirugía , Hematoma/diagnóstico por imagen , Humanos , Masculino , Metacarpo/diagnóstico por imagen , Metacarpo/cirugía , Radiografía , Recuperación de la FunciónRESUMEN
We report a prospective study of 92 articular fractures of the digits. The treatment protocol was based on functional stability and acceptable alignment rather than on joint congruity. 54% of patients had good results, with 22% fair and 24% poor results being recorded. These results are similar to reports of treatment of finger fractures in general and suggest that for articular fractures of the digits, stability and alignment are more important factors than joint congruity in determining short-term outcome. Compound fractures and those associated with comminution, significant soft tissue damage and marked displacement at presentation have a worse prognosis.
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Traumatismos de los Dedos/cirugía , Fijación de Fractura , Fracturas Cerradas/cirugía , Fracturas Abiertas/cirugía , Articulación Metacarpofalángica/lesiones , Articulación Metacarpofalángica/cirugía , Adolescente , Adulto , Anciano , Protocolos Clínicos , Femenino , Humanos , Masculino , Persona de Mediana Edad , Estudios Prospectivos , Resultado del TratamientoRESUMEN
BACKGROUND: Trauma is a major cause of mortality and morbidity worldwide. Methods of assessing outcome have evolved with management of trauma victims. RESULTS AND DISCUSSION: The wide variety of scoring instruments available to assess the injured patient may be divided into three groups: anatomical, physiological and combined systems. Anatomical systems depend on an accurate description of the injuries sustained. Physiological systems measure the effects of injury on the patient's physiological reserves. Combined systems contain elements of both anatomical and physiological scores. Prospectively, scoring systems help in description, triage, treatment decisions and estimating outcome. Retrospective scoring is helpful in audit, in quality control, in comparing treatment methods or centres, and in identifying unexpected outcomes. Limitations may be inherent in the system or may reflect inaccurate or incomplete data collection.
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Índices de Gravedad del Trauma , Escala de Coma de Glasgow , Humanos , Puntaje de Gravedad del TraumatismoRESUMEN
Over a four year period, 20 segments in 16 patients were treated by lengthening by callotasis or chondrodiastasis. The indications for treatment were leg length discrepancy in 13 patients and short stature in three. Patients with leg length discrepancy were all treated by femoral lengthening; the mean length gained was 4.4 cm (range 2.5 to 6.Ocm). For patients with short stature, the mean femoral length gain was 10.0 cm (9.0 to 10.5 cm), and the mean tibial length gain was 8.0 cm (6.5 to 9.0 cm). The commonest problem was pin tract infection, but this always settled with antibiotic therapy. Most other complications were also successfully dealt with, and did not compromise the outcome of treatment. At the time of review, 13 of the 16 patients said they were very happy with the result; two patients were reserving judgement until completion of treatment, and, only one thought the treatment had been of no benefit. Our initial experience, with callotasis in particular, has been that it is a highly satisfactory method of limb lengthening, has an acceptable complication rate, and involves minimal hospitalization as compared with older techniques.
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Alargamiento Óseo/métodos , Fémur/cirugía , Tibia/cirugía , Adolescente , Adulto , Alargamiento Óseo/instrumentación , Callo Óseo/diagnóstico por imagen , Callo Óseo/cirugía , Niño , Femenino , Fémur/diagnóstico por imagen , Humanos , Tiempo de Internación , Masculino , Complicaciones Posoperatorias , Radiografía , Tibia/diagnóstico por imagenRESUMEN
Benign synovioma is a rare cause of symptomatic instability of joints of the lower limb. We report two cases presenting in this way. Arthrotomy is indicated to ensure adequate excision of these lesions if recurrence is to be avoided.
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Articulación del Tobillo , Inestabilidad de la Articulación/etiología , Articulación de la Rodilla , Sarcoma Sinovial/complicaciones , Adulto , Humanos , Artropatías/complicaciones , Artropatías/diagnóstico , Masculino , Persona de Mediana Edad , Sarcoma Sinovial/diagnósticoRESUMEN
Sixteen polytraumatized patients with a variety of unstable pelvic ring fractures were treated with operative fixation. We have found that an aggressive approach with adequate early stabilization of the pelvis offers many advantages over conservative management particularly in polytraumatized patients.
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Fracturas Óseas/cirugía , Traumatismo Múltiple/complicaciones , Huesos Pélvicos/lesiones , Adolescente , Adulto , Anciano , Placas Óseas/normas , Niño , Fijadores Externos/normas , Femenino , Estudios de Seguimiento , Fracturas Óseas/diagnóstico por imagen , Fracturas Óseas/etiología , Humanos , Masculino , Persona de Mediana Edad , Tomografía Computarizada por Rayos XRESUMEN
We present four cases and a review of the literature regarding nail-gun related limb injury. Nail guns have significant potential to cause limb and other major injuries. In most cases improper use of the nail-gun is the single most important factor in causing such types of injuries. Treatment of these injuries requires careful assessment of the limb and the type of nail involved in order to enable safe extraction. We recommend the introduction of training in the workforce to encourage awareness of the danger of such devices. We also emphasize the continuing requirements for improved workplace safety and adequate safety equipment when working with such dangerous devices.
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Accidentes de Trabajo , Traumatismos de los Pies/etiología , Traumatismos de la Mano/etiología , Heridas Penetrantes/etiología , Traumatismos de la Muñeca/etiología , Adulto , Humanos , Masculino , Ocupaciones , SeguridadRESUMEN
BACKGROUND: Presentation of scientific research at national and international meetings is an important forum for the dissemination of knowledge. Subsequent publication of a full-text paper in a peer-reviewed journal is the expected outcome of such presentations. The publication rate from these meetings is highly variable. AIMS: To determine the publication rate of abstracts presented at the Irish Orthopaedic Association's Annual Conference and to determine which factors are associated with progression to full-text publication. METHODS: We reviewed the proceedings from the Irish Orthopaedic Association's National Meeting over a 4 year period. We searched the Pubmed database using author names, institution names, and keywords from each abstract's title, to determine how many presented articles progressed to full-text publication. RESULTS: Sixty-six of 203 were published, 97 % within 5 years of presentation. Laboratory based studies presenting novel or innovative findings were more likely to be published than clinical studies. Clinical studies were more likely to be published if they were prospective and had a longer period of follow-up. Retrospective audits were less likely to be published, even with a large cohort size. Changes in authorship of presented papers were related to a longer delay in time to full-text publication. CONCLUSIONS: Thorough planning of research studies is essential to ensure a timely progression to full-text publication in a peer-reviewed journal. Most studies will be published within 5 years of initial presentation.
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Bibliometría , Congresos como Asunto , Ortopedia , Publicaciones Periódicas como Asunto , Edición/estadística & datos numéricos , Autoria , Investigación Biomédica , Revisión de la Investigación por Pares , PubMedRESUMEN
BACKGROUND: Ireland is currently in the process of establishing a National Joint Registry. AIM: We aim to determine which implants and surgical techniques are currently being used by Irish orthopaedic surgeons and to examine the impact that a National Joint Registry may have on arthroplasty practice in Ireland. METHODS: The study consisted of a postal questionnaire sent to all public service consultant orthopaedic surgeons in The Republic of Ireland. RESULTS: We had a response rate of 76.6 %. Of this 76.6, 86.4 % regularly perform total hip arthroplasty (THA) and 84.7 % perform total knee arthroplasty. Of those who perform THA, 86.3 % use different implants in younger patients. Thirteen different femoral implants are used, and seven different knee implants. We conservatively estimate that at least 3,918 total hip arthroplasties and 2,604 total knee arthroplasties are performed in Ireland each year. At present we have no way to precisely monitor the number of arthroplasty procedures being performed, and we have no way of accurately monitoring the short- or long-term outcomes of the many implants used. CONCLUSIONS: The establishment of a National Joint Registry for Ireland would benefit the Irish orthopaedic community, and given the large number of procedures being performed, may also be of benefit to the international orthopaedic community.
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Artroplastia de Reemplazo de Cadera/estadística & datos numéricos , Artroplastia de Reemplazo de Rodilla/estadística & datos numéricos , Prótesis de Cadera/estadística & datos numéricos , Prótesis de la Rodilla/estadística & datos numéricos , Ortopedia , Pautas de la Práctica en Medicina , Sistema de Registros , Factores de Edad , Anciano , Artroplastia de Reemplazo de Cadera/métodos , Artroplastia de Reemplazo de Rodilla/métodos , Femenino , Humanos , Irlanda , Masculino , Persona de Mediana Edad , Selección de Paciente , Pronóstico , Diseño de Prótesis , Encuestas y Cuestionarios , Factores de TiempoRESUMEN
INTRODUCTION: Ireland is unfamiliar with extreme weather conditions. Such conditions occurred in winter 2009-2010 and 2010-2011, with much of the country being affected by snow and ice. We reviewed the effect that these conditions had on the treatment of ankle fractures in our trauma unit. MATERIALS AND METHODS: The study period was from November until February for four consecutive years from 2008-2009 until 2011-2012. We compared two winters with extreme weather with two winters with regular weather conditions. Information from Met Eireann was compared with demographics from patient records to differentiate ice-related injuries from non-ice-related injuries. Ankle fractures were classified using the Lauge-Hansen classification. We compared waiting times in A&E, waiting times for theatre, delays relating to injury severity, and overall length of stay for both groups. RESULTS: We identified 44 ice-related injuries and 67 non-ice-related injuries. Ice-related injuries trended towards more severe fracture configurations using the Lauge-Hansen classification. Patients sustaining ankle injuries during inclement weather were significantly younger than patients sustaining injuries during regular weather conditions. There were no other significant differences between the two groups. DISCUSSION: Ice-related injuries trended towards a greater severity of fracture configuration. We identified no significant increase in the time to treatment or overall length of stay of patients sustaining ankle fractures during these times. Ice-related injuries did not have greater rates of complications. These results are a testament to the trauma staff in this unit who absorbed the increased workload without compromising patient care.
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Fracturas de Tobillo , Traumatismos del Tobillo/epidemiología , Centros Traumatológicos/estadística & datos numéricos , Tiempo (Meteorología) , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Humanos , Irlanda/epidemiología , Persona de Mediana Edad , Estudios Prospectivos , Adulto JovenRESUMEN
BACKGROUND: Orthopaedic higher surgical trainees in Ireland are allocated to one of eight training rotations. Each trainee is expected to publish at least one research paper per year during training. AIM: To assess the research productivity of each training rotation over a 10-year period. METHODS: A PubMed search was performed for each orthopaedic unit affiliated to higher surgical training (HST) in order to identify full-text research papers published between 2001 and 2010. The results were analysed to determine which training rotations are most productive in terms of research. RESULTS: We identified 267 papers published from 16 units over the 10-year period. There were substantial differences in the number of papers published from each unit, and substantial differences between the eight set trainee rotations. CONCLUSIONS: It is essential that each trainee makes an honest assessment of their potential for conducting and producing valuable and relevant research, and chooses an HST rotation that is appropriate to their needs. Publication of research articles is easier to achieve on some HST rotations than on others.
Asunto(s)
Investigación Biomédica/estadística & datos numéricos , Educación de Postgrado en Medicina/organización & administración , Ortopedia/educación , Investigación Biomédica/tendencias , Eficiencia , Humanos , Irlanda , Edición/estadística & datos numéricosRESUMEN
Six patients with a clinical diagnosis of chronic posterior cruciate ligament (PCL) rupture, based on a positive posterior drawer test, had a normal appearance of the PCL on an MRI scan. It is postulated that the PCL had been ruptured but healed in a lengthened state. 12 volunteers with no history of knee trauma underwent an MRI scan of the knee. In this control group (n = 12), there was a close correlation between the lateral femoral condylar width in the sagittal plane and the PCL length, with a ratio of 2:1 (95% confidence interval (CI) = 1.817-2.095). In the clinically abnormal group (n = 6), the ratio was 1.49:1 (95% CI = 1.206-1.782) (p< 0.0005). In conclusion, the ratio of the lateral femoral condylar width in the sagittal plane to the PCL length is a useful index for diagnosing PCL attenuation and lengthening in the presence of a normal morphological MR appearance.