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1.
J Adv Nurs ; 2024 May 07.
Artigo em Inglês | MEDLINE | ID: mdl-38712897

RESUMO

AIM: To compare student nurses' expectations and newly qualified nurses' experiences regarding clinical practice in Switzerland 1 year after graduation. DESIGN: A secondary explorative analysis of a cross-sectional survey. METHODS: The data were sourced from the Swiss National Graduate Survey of Health Professionals covering six universities of applied sciences between 2016 and 2019, with information on three cohorts of bachelor student nurses, with a 1-year follow-up between each year. The participants were 533 bachelor-prepared nursing graduates. RESULTS: The student nurses' overall expectations included the following top two prioritized aspects: 'contributing to something important' and 'adequate time to spend with patients'. Newly graduated nurses' clinical practice experiences demonstrated that not all expectations were met 1 year after graduation. The largest gaps were found in 'adequate time to spend with patients', 'work-life balance' and experiencing 'good management'. CONCLUSION: The most crucial expectation gaps are related to having sufficient time to spend with patients and a good work-life balance. The most important result is whether there is a shortage of places for nurses to work rather than the oft-cited shortage of nurses. IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE: The expectations of Swiss newly qualified nurses can be better met by an assessment in the first year about which individual perceptions of workplace characteristics cause them to make choices to change something about their work, affect their job satisfaction or influence their intention to stay. IMPACT: Few of the student nurses' expectations were met 1 year after graduation, therefore Swiss healthcare institutions should improve needs assessments to strengthen the nurse workforce starting early in employment. The results underscore the importance of a constructive management culture, such as that in magnet hospitals in the United States which underpins the philosophy of changing in nursing. The results can be used internationally as a benchmark and as a basis for introducing potential interventions for nurse retention. REPORTING METHOD: This study was reported following the Standardized Reporting of Secondary Data Analyses Checklist. PATIENT OR PUBLIC CONTRIBUTION: There were no patient or public contributions. TRIAL AND PROTOCOL REGISTRATION: This study has not been registered.

2.
J Arthroplasty ; 39(5): 1157-1164, 2024 May.
Artigo em Inglês | MEDLINE | ID: mdl-37952739

RESUMO

BACKGROUND: Hip periprosthetic fractures (PPFs) after primary total hip arthroplasty are increasing with the number of primary implants and aging population. Mortality has been reported up to 34% at 1-year. The aim of this study was to evaluate the association of Clinical Frailty Scale (CFS) and 1-year mortality, complication rate, and length of stay (LOS) in surgically managed hip PPFs. METHODS: This was a retrospective study of prospectively collected data from January 2008 to January 2021. A total of 282 surgically managed hip PPFs were identified. Mean age was 79 years (range, 42 to 106). Preoperative scores were analyzed through linear regression to identify significant association with mortality, complication and LOS. Receiver operating characteristic curve and Area Under the Curve (AUC) were generated to evaluate the quality of the models and the discriminatory ability of each clinical score. Significance was considered at P values < .05. RESULTS: Mortality was 7.8% at 3-months and 15.7% at 1-year. Complication rate requiring surgery was 19.5% and mean LOS was 8.9 ± 7 days. The CFS was significantly associated with 3-month (odds ratio 2.23, P < .001) and 1-year mortality (odds ratio 2.01, P < .001). The receiver operating characteristic curve test for 1-year mortality showed a greater AUC for the CFS when compared with American Society for Anesthesiologists score and age-adjusted Charlson Comorbidity Index (AUC 0.80 versus 0.68 versus 0.72, respectively). CONCLUSIONS: Frailty is a syndrome with increased risk of mortality after surgically managed PPF. The CFS can be easily assessed at the time of admission and could be considered as a strong and reliable predictor of 1-year mortality with a greater AUC than the conventionally used American Society for Anesthesiologists score.

3.
J Arthroplasty ; 39(4): 1093-1107.e1, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-37871862

RESUMO

BACKGROUND: Secondary patella resurfacing is often performed for dissatisfaction following primary knee arthroplasty where the native patella was retained. The purpose of this meta-analysis was to evaluate outcomes of secondary patella resurfacing. METHODS: The systematic review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Studies reporting on patients who underwent secondary patella resurfacing after previous primary knee arthroplasty with retention of the native patella were considered eligible. The risk of bias was assessed using the Methodological Index for Non-Randomized studies tool. A random-effects model and the inverse-variance weighting method was used for meta-analysis. There were sixteen retrospective studies including 604 knees (594 patients) with a mean follow up of 42 months (range, 2 to 197). RESULTS: An overall improvement in patient-reported outcomes (PROMs) was achieved in 53% of cases from pooled data available for 293 knees [95% Confidence Interval (CI) (0.44, 0.62), I2=68% - moderate heterogeneity]. The pooled proportion of patients satisfied with the procedure was 59% [95% CI (48, 68), I2 = 70% - moderate heterogeneity] in a sample size of 415. There was a minimal rate (2%) of complication incidence when performing secondary patella resurfacing and a pooled rate of revision surgery of 10%. CONCLUSIONS: An improvement in pain, satisfaction, and PROMs was achieved in slightly more than half of the patients following secondary patella resurfacing. However, studies lacked standardized objective selection criteria for the procedure and the available data was predominantly retrospective, with high heterogeneity and variation in outcome reporting.


Assuntos
Artroplastia do Joelho , Prótese do Joelho , Osteoartrite do Joelho , Humanos , Artroplastia do Joelho/efeitos adversos , Artroplastia do Joelho/métodos , Patela/cirurgia , Estudos Retrospectivos , Dor/cirurgia , Reoperação , Resultado do Tratamento , Articulação do Joelho/cirurgia , Osteoartrite do Joelho/cirurgia
4.
Artigo em Inglês | MEDLINE | ID: mdl-37623155

RESUMO

BACKGROUND: Unconscious biases are one of the causes of health disparities. Health professionals have prejudices against patients due to their race, gender, or other factors without their conscious knowledge. This review aimed to provide an overview of research on unconscious bias among health professionals and to investigate the biases that exist in different regions of the world, the health professions that are considered, and the research gaps that still exist. METHODS: We conducted a scoping review by systematically searching PubMed/MEDLINE, CINAHL, PsycINFO, PsycARTICLES, and AMED. All records were double-screened and included if they were published between 2011 and 2021. RESULTS: A total of 5186 records were found. After removing duplicates (n = 300), screening titles and abstracts (n = 4210), and full-text screening (n = 695), 87 articles from 81 studies remained. Studies originated from North America (n = 60), Europe (n = 13), and the rest of the world (n = 6), and two studies were of global scope. Racial bias was investigated most frequently (n = 46), followed by gender bias (n = 11), weight bias (n = 10), socio-economic status bias (n = 9), and mental illness bias (n = 7). Most of the studies were conducted by physicians (n = 51) and nurses (n = 20). Other health care professionals were rarely included in these studies. CONCLUSIONS: Most studies show that health professionals have an implicit bias. Racial biases among physicians and nurses in the USA are well confirmed. Research is missing on other biases from other regions and other health professions.


Assuntos
Viés Implícito , Médicos , Humanos , Feminino , Masculino , Sexismo , Pessoal de Saúde , Ocupações em Saúde
5.
J Bone Joint Surg Am ; 105(17): 1373-1380, 2023 09 06.
Artigo em Inglês | MEDLINE | ID: mdl-37494460

RESUMO

➤ Young women who are 15 to 45 years of age and undergo total hip replacements are at increased risk for revision compared with women >75 years of age.➤ Among women of childbearing age with a total hip replacement, 12% to 17% will later have at least 1 pregnancy.➤ Young women who undergo total hip replacement do not have an increased risk of pregnancy complications.➤ Of the 60% of women who experienced pain with a total hip replacement during pregnancy, 21% had persisting pain, and 4% reported the pain as severe.➤ Women who have a total hip replacement and later experience pregnancy and childbirth have no increased risk of pregnancy complications or increased revision rates; there was no effect of the mode of delivery on revision rates or complications including fracture, dislocation, or loosening, according to the limited studies available.


Assuntos
Artroplastia de Quadril , Prótese de Quadril , Gravidez , Humanos , Feminino , Artroplastia de Quadril/efeitos adversos , Falha de Prótese , Quadril , Prótese de Quadril/efeitos adversos , Dor/etiologia , Artralgia/etiologia , Reoperação/efeitos adversos , Seguimentos , Estudos Retrospectivos
6.
BMC Musculoskelet Disord ; 24(1): 518, 2023 Jun 23.
Artigo em Inglês | MEDLINE | ID: mdl-37353764

RESUMO

BACKGROUND: Musculoskeletal pain, especially back pain, is common among health care professionals (HP). For prevention purposes, it is important to know whether HP develop their symptoms before or after entering the health care workforce. Cross-sectional studies among HP cannot answer this question. This follow-up study measures the prevalence and individual course of musculoskeletal pain among full-time HP students at the end of their studies and one year after entering the health care workforce. METHOD: Self-reported one-year prevalence for low back pain, neck/shoulder pain, pain in arms/hands, and pain in legs/feet was collected at two timepoints from 1046 participating HP using an online questionnaire. Participants were asked whether their musculoskeletal pain was related to study or work conditions. Generalized estimating equation (GEE) models of the binomial family with log link were used to estimate adjusted prevalence and corresponding normal based 95% confidence intervals were derived using the bootstrap method with 1000 replications. RESULTS: The prevalence of low back pain as well as neck and shoulder pain was very high at baseline and follow-up in all full-time students and later HP. Prevalence for pain in arms/hands, legs/feet was low and there were significant differences between the professions. HP clearly associated their low back pain and neck/shoulder pain with study and work conditions; HP strongly associated pain in arms/hands, legs/feet only with work conditions. CONCLUSION: Many HP suffer from back/neck/shoulder pain already as students before starting their professional career. The prevention of back/neck/shoulder pain must be part of the education of all health professions at universities. As an example of best practice, universities should incorporate ergonomic measures and exercises into the daily routine of training health professionals. The effects of physically demanding professional tasks on the upper and lower extremities need to be investigated in further studies to take preventive measures.


Assuntos
Dor Lombar , Dor Musculoesquelética , Humanos , Dor Musculoesquelética/diagnóstico , Dor Musculoesquelética/epidemiologia , Dor Lombar/epidemiologia , Dor de Ombro/diagnóstico , Dor de Ombro/epidemiologia , Seguimentos , Suíça/epidemiologia , Estudos Transversais , Inquéritos e Questionários , Pessoal de Saúde
7.
J Orthop Surg (Hong Kong) ; 31(1): 10225536231153232, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-36655735

RESUMO

PURPOSE: Since its introduction in 1988, the double-tapered polished Exeter cemented stem has been widely adopted in primary total hip arthroplasty (THA). Despite the results coming from the arthroplasty registries have proven great survivorship, the aim of this study was to dig deeper and describe the modes of failure of the Exeter stem at 15 years follow-up while reporting the clinical and radiographic outcomes. METHODS: A search of PubMed, MEDLINE, and Embase was performed using the Preferred Reporting Items for Systematic Review and Meta-Analyses since inception of database to January 2022. A meta-analysis was performed on stem's failure rates and clinical outcomes using random effects models. Publication bias was assessed with funnel plots. RESULTS: Overall, ten studies met the inclusion criteria with 2167 hips at mean 14.8 ± 4.1 years follow-up. The meta-effect estimate for revision rate for stem-related reasons was 3.8% (CI 95% 2.1-5.6, p < 0.01). The meta-effect for revision rate for stem aseptic loosening (AL) was 0.22% (CI 95% 0-0.4, p = 0.048) and for periprosthetic fracture was 0.6% (CI95% 0.3-0.9, p < 0.001). The meta effect estimate for Oxford Hip Score (OHS) at final follow-up was 32.4 (moderate; CI 95% 23.2-41.6, p <0.001) with and heterogeneity among the studies of I2 0%. Radiolucent lines were reported in 5.5% of cases, with 1.0% of cases (21 hips) reported to be progressive. CONCLUSION: Current evidence suggests that the Exeter cemented stem not only has proven long-term outstanding reliability with a revision rate of 3.8%, but also incredibly low revision rates for AL (0.22%) and periprosthetic fracture (0.6%). It is suitable for a variety of indications, and the consistent radiological appearances indicate durable fixation and load transmission while being associated with a remarkably low stem-related complication rate.


Assuntos
Artroplastia de Quadril , Prótese de Quadril , Fraturas Periprotéticas , Humanos , Fraturas Periprotéticas/cirurgia , Reprodutibilidade dos Testes , Seguimentos , Reoperação , Falha de Prótese , Desenho de Prótese , Fêmur/cirurgia , Artroplastia de Quadril/métodos , Cimentos Ósseos
8.
Environ Toxicol Chem ; 41(10): 2512-2526, 2022 10.
Artigo em Inglês | MEDLINE | ID: mdl-35876436

RESUMO

Estrogens are released to the aquatic environment by wastewater treatment plant (WWTP) effluents and can affect wildlife. In the last three decades, many in vitro assay platforms have been developed to detect and quantify estrogenicity in water. In 2018, the International Organization for Standardization (ISO) standardized protocols became available for three types of in vitro estrogen receptor transactivation assays (ERTAs) detecting estrogenicity in 96-well plates (ISO19040 1-3). Two ERTAs-lyticase Yeast Estrogen Screen (L-YES) and Arxula YES (A-YES)-use genetically modified yeast strains, whereas the third utilizes stably transfected human cells. One human cell based assay is ERα-CALUX, which is based on a genetically modified human bone osteosarcoma cell line. In the present study, we characterized the performance, comparability, and effectiveness of these three ERTAs, including an evaluation involving proposed water quality thresholds (effect-based trigger values [EBTs]). For a robust evaluation, we collected 52 effluent samples over three sampling campaigns at 15 different WWTPs in Switzerland. Estrogen receptor transactivation assay results were correlated and compared with results from chemical analysis targeting known estrogens. The three ERTAs showed comparable data over all campaigns. However, the selection of EBTs plays a significant role in the interpretation and comparison of bioassay results to distinguish between acceptable and unacceptable water quality. Applying a fixed cross-assay EBT for effluent of 4 ng L-1 resulted in varying numbers of threshold exceedances ranging between zero and four samples depending on the ERTA used. Using assay-specific EBTs showed exceedances in eight samples (ERα-CALUX) and in one sample (A-YES), respectively. Thus, proposed EBTs do not produce similar risk profiles across samples and further refinement of assay-specific EBTs is needed to account for assay-specific differences and to enable the application of ERTAs as effect-based methods in environmental monitoring. Environ Toxicol Chem 2022;41:2512-2526. © 2022 The Authors. Environmental Toxicology and Chemistry published by Wiley Periodicals LLC on behalf of SETAC.


Assuntos
Receptor alfa de Estrogênio , Poluentes Químicos da Água , Bioensaio/métodos , Monitoramento Ambiental/métodos , Estradiol/análise , Receptor alfa de Estrogênio/metabolismo , Estrogênios/análise , Estrogênios/toxicidade , Estrona/análise , Humanos , Receptores de Estrogênio/metabolismo , Padrões de Referência , Saccharomyces cerevisiae/metabolismo , Ativação Transcricional , Poluentes Químicos da Água/análise , Poluentes Químicos da Água/toxicidade
9.
Sci Rep ; 11(1): 6457, 2021 03 19.
Artigo em Inglês | MEDLINE | ID: mdl-33742042

RESUMO

This paper reports investigations led on the combination of the refractive index and morphological dilation to enhance performances towards breast tumour margin delineation during conserving surgeries. The refractive index map of invasive ductal and lobular carcinomas were constructed from an inverse electromagnetic problem. Morphological dilation combined with refractive index thresholding was conducted to classify the tissue regions as malignant or benign. A histology routine was conducted to evaluate the performances of various dilation geometries associated with different thresholds. It was found that the combination of a wide structuring element and high refractive index was improving the correctness of tissue classification in comparison to other configurations or without dilation. The method reports a sensitivity of around 80% and a specificity of 82% for the best case. These results indicate that combining the fundamental optical properties of tissues denoted by their refractive index with morphological dilation may open routes to define supporting procedures during breast-conserving surgeries.


Assuntos
Neoplasias da Mama/diagnóstico por imagem , Carcinoma/diagnóstico por imagem , Processamento de Imagem Assistida por Computador/métodos , Margens de Excisão , Refratometria/métodos , Neoplasias da Mama/patologia , Neoplasias da Mama/cirurgia , Carcinoma/patologia , Carcinoma/cirurgia , Diagnóstico por Imagem/métodos , Feminino , Humanos , Análise Espectral/métodos
10.
Membranes (Basel) ; 10(12)2020 Dec 07.
Artigo em Inglês | MEDLINE | ID: mdl-33297532

RESUMO

Isoporous membranes can be prepared by a combination of self-assembly of amphiphilic block copolymers and the non-solvent induced phase separation process. As the general doctor-blade technique suffers from high consumption of expensive block copolymer, other methods to reduce its concentration in the casting solution are sought after. Decreasing the block copolymer concentration during membrane casting and applying the block copolymer solution on a support membrane to obtain ultrathin isoporous membrane layers with e.g., spraying techniques, can be an answer. In this work we focused on the question if upscaling of thin block copolymer membranes produced by spraying techniques is feasible. To upscale the spray coating process, three different approaches were pursued, namely air-brush, 1-fluid nozzles and 2-fluid nozzles as generally used in the coating industry. The different spraying systems were implemented successfully in a membrane casting machine. Thinking about future development of isoporous block copolymer membranes in application it was significant that a continuous preparation process can be realised combining spraying of thin layers and immersion of the thin block copolymer layers in water to ensure phase-separation. The system was tested using a solution of polystyrene-block-poly(4-vinylpyridine) diblock copolymer. A detailed examination of the spray pattern and its homogeneity was carried out. The limitations of this method are discussed.

11.
Hip Int ; 30(4): 481-487, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-32323587

RESUMO

PURPOSE: Modular Morse tapered femoral arthroplasty stems have been used for many years with great success and minimal complications. 1 stem, the Accolade by Stryker is noted to have increased failure when used in combination with LFIT V40 CoCr or the MITCH CoCr femoral heads. The failure has been in the form of corrosion, metallosis, fretting and trunnion fracture. This paper explores 10 cases with trunnion failure. METHODS: A retrospective retrieval analysis of ten femoral stems retrieved at four different centres across Western Australia over a 3-year time frame. Inclusion criteria for this analysis included the use of Accolade 1 TMZF femoral stem plus either a MITCH or LFIT modular head. RESULTS: 10 Accolade I (Stryker) stems were retrieved as part of the analysis, 6 with the LFIT V40 36-mm femoral head and 4 with a MITCH TRH femoral head. Average in situ time was 8.9 years. The hips were revised for either trunnion dislocation (6 cases) or trunnion fracture (4 cases). A characteristic destructive wear pattern of the femoral taper (trunnion) a "bird beak" appearance was present in all stems. This wear pattern created excessive movement and loosening resulting in a trunnion/head dislocation or brittle fracture of the trunnion. CONCLUSIONS: Catastrophic femoral neck fracture was likely due to a combination of material composition mismatch and mechanically assisted fretting corrosion at the head-neck junction leading to gross metallosis and failure. We suggest a recall on patients with an Accolade 1 stems in combination with a 36-mm or above LFIT or MITCH head, and for these patients to have clinical and radiological review.


Assuntos
Artroplastia de Quadril/efeitos adversos , Artroplastia de Quadril/instrumentação , Prótese de Quadril/efeitos adversos , Fraturas Periprotéticas/etiologia , Falha de Prótese/efeitos adversos , Adulto , Idoso , Idoso de 80 Anos ou mais , Ligas de Cromo , Corrosão , Análise de Falha de Equipamento , Feminino , Fêmur/cirurgia , Humanos , Masculino , Pessoa de Meia-Idade , Desenho de Prótese , Estudos Retrospectivos
12.
Anal Bioanal Chem ; 411(10): 2057-2069, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-30734083

RESUMO

Ecotoxicological screening of surface waters can involve multiple analyses using multiple bioassay and chemical analytical methods that require enriched samples to reach low concentrations. Such broad screening of the same sample necessitates sufficient sample volume-typically several liters-to produce a sufficient amount of enriched sample. Often, this is achieved by performing parallel solid-phase extractions (SPE) where extracts are combined into a pool-this is a laborious process. In this study, we first validated our existing SPE method for the chemical recovery of an extended set of compounds. We spiked four estrogenic compounds and 11 herbicides to samples from independent rivers (1 L) and wastewater treatment plant effluents (0.5 L). Then, we investigated the effect of increased sample loading of the SPE cartridges on both chemical and biological recoveries by comparing the validated volumes with four times larger sample volumes (i.e., 4 L river water and 2 L effluent). Samples were analyzed by LC-MS/MS and three bioassays: an estrogen receptor transactivation assay (ERα-CALUX), the combined algae test, and a bacterial bioluminescence inhibition assay. Our existing SPE method was found to be suitable for enriching the extended set of estrogens and herbicides in river water and effluents with near to perfect chemical recoveries (~ 100%), except for the herbicide metribuzin (46 ± 19%). In the large volume river and effluent samples, the biological activities and concentrations of the spiked compounds were between 87 and 104% of those measured with the lower sample loading, which is adequate. In addition, the ratio between the large and original volume SPE method for the non-target endpoint (bacterial bioluminescence inhibition) was acceptable (on average 82 ± 9%). Results indicate that our current water extraction method can be applied to up to four times larger sample volumes, resulting in four times more extract volumes, without significant reductions in recoveries for the tested estrogens and herbicides. Graphical abstract ᅟ.


Assuntos
Monitoramento Ambiental/métodos , Estrogênios/isolamento & purificação , Herbicidas/isolamento & purificação , Extração em Fase Sólida/métodos , Poluentes Químicos da Água/isolamento & purificação , Bactérias/efeitos dos fármacos , Clorófitas/efeitos dos fármacos , Cromatografia Líquida/métodos , Exposição Ambiental/efeitos adversos , Exposição Ambiental/análise , Estrogênios/toxicidade , Herbicidas/toxicidade , Rios/química , Espectrometria de Massas em Tandem/métodos , Testes de Toxicidade/métodos , Águas Residuárias/análise , Poluentes Químicos da Água/toxicidade
13.
BMC Public Health ; 18(1): 1188, 2018 Oct 19.
Artigo em Inglês | MEDLINE | ID: mdl-30340573

RESUMO

BACKGROUND: Low back pain (LBP) and neck pain (NP) are of considerable socioeconomic burden. Considering the escalating demand on health services that LBP and NP have globally, they represent an arguably unsustainable drain on resources with the projected increased demand secondary to an ageing population. Identifying populations at risk for LBP and NP may inform public health prevention strategies. Health professions' (HP) students may be more susceptible due to their demographic factors and potentially risky postural demands of their education and formative clinical practice. The aim of our study was to compare self-reported LBP and NP of HP students with the general and stratified Swiss population to identify their prevalence. In addition, we compared the prevalence of LBP and NP in students studying different professions in order to identify whether susceptibilities exist. METHODS: In this cross-sectional study, self-reported LBP and NP reported by final-year HP students (n = 1848) were compared with the Swiss national population aged ≥15 years living in private households (n = 21,597). Binary regression models estimated crude prevalence and prevalence adjusted for age, gender, and education. Design-based F-Tests assessed differences between students and the Swiss population. RESULTS: Crude, overall four-week (4w) prevalence (mean (95% CIs)) for LBP was 61.0% (58.4-63.5) in all HP students versus 40.0% (39.2-40.9) in the Swiss population. Female HP students aged 21-30 years (63.3% (60.5-66.1)) reported higher LBP than the same-aged Swiss female population with secondary (43.7% (39.5-47.9)) or tertiary (36.6% (30.8-42.9)) education. Crude, overall 4w prevalence for NP was 59.8% (57.2-62.3) in all HP students versus 36.4% (35.6-37.3) in the Swiss population. Female health professions' students aged 21-30 years reported higher NP (63.2% (60.4-66.0)) than the same-aged Swiss female population with secondary (36.6% (32.7-40.8)) or tertiary (35.4% (29.6-41.8)) education. The inter-professional differences shown indicate midwifery to be most susceptible to reporting both conditions. CONCLUSIONS: Considerably higher LBP and NP were reported by final year HP students when compared with the general and stratified Swiss population. Worrying inter-professional susceptibilities were shown and reveal the need for further explanatory studies. Measures to reduce complex health problems like LBP and NP should be introduced into curricula in order to optimize the longevity of clinical careers and to protect the future HP workforce.


Assuntos
Suscetibilidade a Doenças , Dor Lombar/epidemiologia , Cervicalgia/epidemiologia , Estudantes de Ciências da Saúde/estatística & dados numéricos , Adulto , Estudos Transversais , Feminino , Humanos , Masculino , Prevalência , Suíça/epidemiologia , Adulto Jovem
14.
Membranes (Basel) ; 8(3)2018 Aug 06.
Artigo em Inglês | MEDLINE | ID: mdl-30082598

RESUMO

In this work we present a method to manufacture flat sheet membranes with a thin isoporous block copolymer (BCP) layer (thickness <3 µm) by profile roller coating (breadth: 30 cm) on top of a porous support membrane. Highly diluted BCP-solutions were used for this coating process. While we cast membranes with dimensions of 30 cm × 50 cm in this work, the procedure can easily be extended to endless dimensions in this roll to roll (R2R) process. The method offers the possibility to save >95% of BCP raw material compared to common doctor blade casting, by strongly decreasing the layer thickness to below 3 µm in combination with a highly open substructure. Additionally, we report a straightforward method to investigate the influence of the solvent evaporation time between coating and precipitation (phase inversion) on the membrane morphology using one sample only, which also ensures that all other influencing parameters remain constant.

15.
Hip Int ; 28(1): 74-83, 2018 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-28967055

RESUMO

INTRODUCTION: Hip abductor tendon (HAT) tearing is commonly implicated in greater trochanteric pain syndrome. Surgical studies are often reported in small cohorts and with limited information on functional improvement. This study reports the clinical and functional outcomes after HAT repair. METHODS: 112 patients with symptomatic HAT tears, diagnosed via magnetic resonance imaging, underwent open bursectomy, V-Y lengthening of the iliotibial band, debridement of the diseased tendon, decortication of the trochanteric foot-plate and reattachment of the tendon with suture anchors, augmented with a LARS ligament through a trans-osseous tunnel. Patients were evaluated pre-surgery and at 3, 6 and 12 months post-surgery using the Harris (HHS) and Oxford (OHS) Hip Scores, SF-12, hip range of motion, 6-minute walk and 30-second single leg stance tests. Maximal isometric hip abduction strength (HAS) was assessed and limb symmetry indices (LSIs) were calculated between the operated and non-operated limbs. Patient satisfaction and perceived global rating of change (GRC) was evaluated. Analysis of variance evaluated improvement over time. RESULTS: There was a significant improvement (p<0.05) in all clinical and functional measures. HAS significantly improved over time (p<0.002) and all LSIs were >85% at 12 months. At 12 months, a mean GRC score of 3.5 (range -1 to 5) was reported, while 96% of patients were satisfied with their surgical outcome. There was a 2.7% (n = 3) failure rate at 12 months. CONCLUSIONS: HAT reconstruction, augmented with a synthetic ligament, demonstrated significantly improved clinical and functional outcomes, high levels of patient satisfaction and a low failure rate to 12 months post-surgery.


Assuntos
Artroplastia/métodos , Lesões do Quadril/cirurgia , Traumatismos dos Tendões/cirurgia , Adulto , Idoso , Idoso de 80 Anos ou mais , Estudos de Coortes , Feminino , Fêmur/cirurgia , Humanos , Imageamento por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Satisfação do Paciente , Recuperação de Função Fisiológica , Resultado do Tratamento
16.
Sci Total Environ ; 621: 612-625, 2018 Apr 15.
Artigo em Inglês | MEDLINE | ID: mdl-29195208

RESUMO

Endocrine-active substances can adversely impact the aquatic ecosystems. A special emphasis is laid, among others, on the effects of estrogens and estrogen mimicking compounds. Effect-based screening methods like in vitro bioassays are suitable tools to detect and quantify endocrine activities of known and unknown mixtures. This study describes the validation of the Arxula-Yeast Estrogen Screen (A-YES®) assay, an effect-based method for the detection of the estrogenic potential of water and waste water. This reporter gene assay, provided in ready to use format, is based on the activation of the human estrogen receptor alpha. The user-friendly A-YES® enables inexperienced operators to rapidly become competent with the assay. Fourteen laboratories from four countries with different training levels analyzed 17ß-estradiol equivalent concentrations (EEQ) in spiked and unspiked waste water effluent and surface water samples, in waste water influent and spiked salt water samples and in a mixture of three bisphenols. The limit of detection (LOD) for untreated samples was 1.8ng/L 17ß-estradiol (E2). Relative repeatability and reproducibility standard deviation for samples with EEQ above the LOD (mean EEQ values between 6.3 and 20.4ng/L) ranged from 7.5 to 21.4% and 16.6 to 28.0%, respectively. Precision results are comparable to other frequently used analytical methods for estrogens. The A-YES® has been demonstrated to be an accurate, precise and robust bioassay. The results have been included in the ISO draft standard. The assay was shown to be applicable for testing of typical waste water influent, effluent and saline water. Other studies have shown that the assay can be used with enriched samples, which lower the LOD to the pg/L range. The validation of the A-YES® and the development of a corresponding international standard constitute a step further towards harmonized and reliable bioassays for the effect-based analysis of estrogens and estrogen-like compounds in water samples.


Assuntos
Monitoramento Ambiental/métodos , Receptor alfa de Estrogênio/metabolismo , Estrogênios/análise , Saccharomycetales , Poluentes Químicos da Água/análise , Bioensaio , Disruptores Endócrinos , Estradiol/análise , Humanos , Limite de Detecção , Fenóis/análise , Reprodutibilidade dos Testes
17.
Membranes (Basel) ; 7(4)2017 Dec 16.
Artigo em Inglês | MEDLINE | ID: mdl-29258193

RESUMO

Porous polyethersulfone membranes as used in oenology were investigated in order to evaluate temperature-dependent permeances in a temperature range from 10 to 35 °C. A temperature correction factor was determined for this type of membrane to get accurate and comparable results for further developments. Moreover, the membranes were modified with a bio-inspired polydopamine coating in order to reduce fouling. The performance of the membranes could be increased with respect to permeance and flux recovery under cross-flow conditions. In order to test the applicability and stability of the coating layer, they were treated with basic and acidic cleaning agents as used in industry for fouled membranes. The chemical stability of the coating layer was studied under basic and acidic conditions, by systematic observation of the colour change of the coated membranes over treatment time.

18.
Orthop J Sports Med ; 5(2): 2325967116688866, 2017 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-28321422

RESUMO

BACKGROUND: Gluteal tendinopathy is a common cause of lateral hip pain, and existing conservative treatment modalities demonstrate high symptom recurrence rates. Autologous tenocyte injection (ATI) is a promising cell therapy that may be useful for the treatment of gluteal tendinopathy. PURPOSE: To investigate the safety and effectiveness of ATI, specifically in patients with chronic recalcitrant gluteal tendinopathy. STUDY DESIGN: Case series; Level of evidence, 4. METHODS: Twelve female patients with a clinical and radiological diagnosis of gluteal tendinopathy were recruited. Patients demonstrated a mean duration of symptoms of 33 months (range, 6-144 months), had undergone a mean 3.2 prior corticosteroid injections (range, 2-5), and had failed to respond to existing conservative treatments including physiotherapy and injections. In an initial procedure, tendon cells were harvested from a needle biopsy of the patella tendon and propagated in a certified Good Manufacturing Practice (GMP) laboratory. In a secondary procedure, a single injection of 2 mL autologous tenocytes (2-5 × 106 cells/mL) suspended in patient serum was injected into the site of the pathological gluteal tendons under ultrasound guidance. Patients were assessed pre- and postinjection (3, 6, 12, and 24 months) using the Oxford Hip Score (OHS), a visual analog pain scale (VAS), the Short Form-36 (SF-36), and a satisfaction scale. Magnetic resonance imaging (MRI) was undertaken at 8.7 months (range, 6-12 months) postinjection. RESULTS: Molecular characterization of autologous tendon cells showed a profile of growth factor production in all cases, including platelet-derived growth factor α, fibroblast growth factor ß, and transforming growth factor ß. The OHS (mean, 24.0 preinjection to 38.9 at 12 months [14.9-point improvement]; 95% CI, 10.6-19.2; P < .001), VAS (mean, 7.2 preinjection to 3.1 at 12 months [4.1-point improvement]; 95% CI, 2.6-5.6; P < .001), and SF-36 (mean, 28.1 preinjection to 43.3 at 12 months [15.2-point improvement]; 95% CI, 9.8-20.5; P < .001) significantly improved to 12 months postinjection, sustained to 24 months. Eight patients were satisfied with their outcomes. Significant MRI-based improvement could not be demonstrated in the majority of cases. CONCLUSION: ATI for gluteal tendinopathy is safe, with improved and sustained clinical outcomes to 24 months.

19.
Mol Ecol Resour ; 15(6): 1486-96, 2015 11.
Artigo em Inglês | MEDLINE | ID: mdl-25865627

RESUMO

Although linkage maps are important tools in evolutionary biology, their availability for wild populations is limited. The population of song sparrows (Melospiza melodia) on Mandarte Island, Canada, is among the more intensively studied wild animal populations. Its long-term pedigree data, together with extensive genetic sampling, have allowed the study of a range of questions in evolutionary biology and ecology. However, the availability of genetic markers has been limited. We here describe 191 new microsatellite loci, including 160 high-quality polymorphic autosomal, 7 Z-linked and 1 W-linked markers. We used these markers to construct a linkage map for song sparrows with a total sex-averaged map length of 1731 cM and covering 35 linkage groups, and hence, these markers cover most of the 38-40 chromosomes. Female and male map lengths did not differ significantly. We then bioinformatically mapped these loci to the zebra finch (Taeniopygia guttata) genome and found that linkage groups were conserved between song sparrows and zebra finches. Compared to the zebra finch, marker order within small linkage groups was well conserved, whereas the larger linkage groups showed some intrachromosomal rearrangements. Finally, we show that as expected, recombination frequency between linked loci explained the majority of variation in gametic phase disequilibrium. Yet, there was substantial overlap in gametic phase disequilibrium between pairs of linked and unlinked loci. Given that the microsatellites described here lie on 35 of the 38-40 chromosomes, these markers will be useful for studies in this species, as well as for comparative genomics studies with other species.


Assuntos
Mapeamento Cromossômico , Repetições de Microssatélites , Pardais/classificação , Pardais/genética , Animais , Canadá , Biologia Computacional , Feminino , Tentilhões/genética , Masculino , Dados de Sequência Molecular , Recombinação Genética , Análise de Sequência de DNA , Sintenia
20.
Hip Int ; 25(1): 15-23, 2015.
Artigo em Inglês | MEDLINE | ID: mdl-25198307

RESUMO

Advanced hip imaging and surgical findings have demonstrated that a common cause of greater trochanteric pain syndrome (GTPS) is gluteal tendon tears. Conservative measures are initially employed to treat GTPS and manage gluteal tears, though patients frequently undergo multiple courses of non-operative treatment with only temporary pain relief. Therefore, a number of surgical treatment options for recalcitrant GTPS associated with gluteal tears have been reported. These have included open trans-osseous or bone anchored suture techniques, endoscopic methods and the use of tendon augmentation for repair reinforcement. This review describes the anatomy, pathophysiology and clinical presentation of gluteal tendon tears. Surgical techniques and patient reported outcomes are presented. This review demonstrates that surgical repair can result in improved patient outcomes, irrespective of tear aetiology, and suggests that the patient with "trochanteric bursitis" should be carefully assessed as newer surgical techniques show promise for a condition that historically has been managed conservatively.


Assuntos
Artroscopia/métodos , Lesões do Quadril/cirurgia , Traumatismos dos Tendões/cirurgia , Tendões/cirurgia , Lesões do Quadril/diagnóstico , Humanos , Imageamento por Ressonância Magnética , Ruptura , Traumatismos dos Tendões/diagnóstico
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