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Dangerous outcomes of hollywood electro-magnetic discipline on albino rodents and also protecting position associated with Rosmarinus officinalis.
01). An oral Stenotrophomonas relative abundance of 36% predicted infection (sensitivity 96%, specificity 93%). No association of S. maltophilia infection with fecal relative abundance was found. Cumulative meropenem exposure was associated with increased infection risk (hazard ratio [HR] 1.17, 95% CI 1.01 - 1.35, p = 0.03). Conclusions Herein, we identify the oral microbiome as a potential source for S. maltophilia infection and highlight cumulative carbapenem use as a risk factor for S. maltophilia in leukemia patients. These data suggest that real-time molecular monitoring of the oral cavity might identify patients at high risk for S. maltophilia infection.Background Increasing demand for musculoskeletal care necessitates efficient scheduling and matching of patients with the appropriate provider. However, up to 47% to 60% of orthopedic visits are made without formal triage. The purpose of this study was to develop a method to identify, prior to the initial office visit, the probability that a patient with shoulder symptoms will need surgery so that he or she can be appropriately matched with an operative or nonoperative provider. We hypothesized that patients who had an injury, previously saw an orthopedic provider, or previously underwent magnetic resonance imaging on the affected shoulder would be more likely to undergo surgery. Methods Drawing from expert opinion on potential risk factors (which could be identified prior to the initial office visit) for requiring operative intervention for a chief complaint of shoulder symptoms, we developed a branching-logic questionnaire that required a maximum of 7 responses from the patient during the scheduling process. We administered the questionnaire to patients calling with a chief complaint of shoulder symptoms at the time of initial appointment scheduling in a sports health network. A chart review was later completed to determine the ultimate treatment (operative vs. nonoperative) of each patient's complaint. A multivariate predictive model was then developed to determine the characteristics of patients with a higher surgical risk. Results We successfully developed a model capable of determining surgical risk from 7% to 90% based on patient sex, previous magnetic resonance imaging status, and injury status. Conclusions Our predictive model can aid in patient clinical scheduling and ensure optimal matching of a patient with the best provider for the patient's care. Decreased wait times and appropriate matching may lead to increased patient satisfaction, superior outcomes, and more efficient use of health care resources.Background Shoulder arthroplasty, especially reverse shoulder arthroplasty (RSA), continues to increase in volume. Limitations in internal rotation can be challenging following RSA. Current patient-reported outcome measures are limited in assessing a patient's functional internal rotation following shoulder arthroplasty. To address this limitation, a questionnaire was developed. Methods A single-center prospective comparative cohort study was performed to determine the reliability of the questionnaire. A pilot group of patients who had at least 1 year of follow-up following shoulder arthroplasty was asked to complete the questionnaire. Reliability testing was performed using Cronbach's alpha test. Additionally, individual questions and total questionnaire scores were compared between patients who underwent anatomic total shoulder arthroplasty (TSA) and RSA. Results The questionnaire showed high reliability with all questions. A group of 23 anatomic TSA and 20 RSA patients were compared. RSA patients scored significantly lower on the questionnaire (35.2 out of 50 vs. 43.9, P = .001). Conclusion The questionnaire can be used in conjunction with other patient-reported outcome measures to help surgeons better assess patients' results following shoulder arthroplasty. The initial findings from our internal reliability study found that RSA patients had significantly lower scores and higher variability in internal rotation function vs. patients with TSA. Further studies are needed to determine the clinical importance of this questionnaire.Background Recently, a shorter version of the Western Ontario Rotator Cuff Index (Short-WORC) was created to reduce patient response burden. However, it has yet to be evaluated prospectively for reproducibility (reliability and agreement) and floor and ceiling effects. Methods Patients (N = 162) with rotator cuff disorders completed the Short-WORC at baseline. From this cohort, 47 patients underwent measurement of test-retest reliability within 2 to 7 days. We used the Cronbach α to determine internal consistency and the intraclass correlation coefficient (ICC2,1) to assess test-retest reliability. To evaluate parameters of agreement, the standard error of measurement, minimal detectable change (based on a 90% confidence interval), and Bland-Altman plots were used. Results The Cronbach α was 0.82 at baseline, and the intraclass correlation coefficient (ICC2,1) was 0.87. The agreement parameter was 8.4 for the standard error of measurement of agreement, and the limits of agreement fell within the range of -22.9 to 23.8. The Short-WORC is reliable over time and reflective of a patient's true score after an intervention. Conclusions The Short-WORC demonstrated strong reproducibility parameters and can be used for patients with rotator cuff disorders. The Short-WORC indicated no systematic bias and was reflective of the true score of both individual patients and groups of patients at 2 time points.Background Reverse total shoulder arthroplasty (RTSA) can lead to limited postoperative internal rotation (IR). We assessed how IR is measured and reported in the RTSA literature and examined the relationships between these measures and patient-reported ability to perform activities of daily living. Methods We searched MEDLINE, Embase, and the Cochrane Central Register of Controlled Trials for articles published in English from January 2000 through September 2018 that reported clinical outcomes after RTSA (minimum 12-month follow-up). We included studies reporting IR range of motion (ROM) and/or patient-reported functional outcomes related to IR. We identified 255 studies, 35% of which were excluded because they reported no IR outcome measures, leaving 165 studies for analysis. Results Studies reported 3 methods of measuring IR ROM (1) vertebral level (VL) method (ie, the most proximal VL reached by the extended thumb with the arm behind the back), (2) degrees of IR with the arm abducted to 90°, and (3) degrees of IR with the arm in a neutral position. The VL measurement was reported in 89% of studies, but the methods of reporting this measure varied. Only 9% of studies reported functional outcomes related to IR. No study correlated clinical measurements of IR ROM with functional outcomes. Conclusions Measures and reporting of shoulder IR after RTSA varied widely. This variability makes it difficult to assess associations between postoperativce IR limitation and functional abilities. Standardization of IR measures and reporting is needed to allow meta-analysis of data related to this important outcome.Background This study aimed to determine the toileting ability (TA) of patients undergoing primary reverse total shoulder arthroplasty (RTSA) and identify factors associated with TA postoperatively. Methods A questionnaire regarding toileting was administered to 119 patients who underwent primary RTSA with a minimum 1-year follow-up. Patients were separated into 2 groups based on whether the arm that underwent RTSA was the one used for toileting (study group, n = 74) or not (control group, n = 45). Patient-reported TA was calculated both before and after RTSA. Multivariate analysis was performed to identify factors associated with TA postoperatively. Results Impairment in TA before RTSA was higher in the study group and affected almost three-quarters of the patients (72%). In the study group, primary RTSA resulted in a statistically significant improvement in TA (P less then .001), and no difference in TA was found between groups after RTSA (P = .076). Postoperatively, 92% of the patients in the study group were able to manage toileting with the involved extremity (54% without difficulty and 38% with some degree of difficulty). Only 1 patient (1.3%) was totally unable to manage toileting with either arm postoperatively. The patients at risk of toileting difficulties postoperatively were those who had preoperative toileting difficulties and lower postoperative internal rotation range of motion. Conclusions Over 90% of patients can manage toileting after primary RTSA, and total toileting inability is rare after the procedure (1.3%). Patients should be counseled that after primary RTSA, they have a high probability of being able to manage toileting with independence even if it is with some difficulty.Background The purpose of this multicenter, prospective study was to evaluate the efficacy and safety of a stemless total shoulder arthroplasty compared with a traditional stemmed control. Methods Ninety-five shoulders were selected for participation in this Food and Drug Administration investigational device exemption clinical trial and underwent stemless total shoulder arthroplasty. Subjects returned for follow-up at 6 weeks, 6 months, 12 months, and 2 years postoperatively. Outcome measures included pain; range of motion; American Shoulder and Elbow Surgeons, Western Ontario Osteoarthritis of the Shoulder, and Short Form 12 scores; and radiographic review. Baseline data were compared with 2-year follow-up data to determine the rate of composite clinical success compared with the stemmed control. Results All outcome assessments demonstrated significant improvements (P ≤ .007). Staurosporine The mean American Shoulder and Elbow Surgeons score improved from 20 to 89 (P less then .0001), and the mean shoulder pain score decreased from 8.3 ± 1.6 to 0.7 ± 1.5 (P less then .0001). The mean Western Ontario Osteoarthritis of the Shoulder score decreased from 1443 ± 256 to 203 ± 267 (P less then .0001). On the Short Form 12, the mean physical health score increased from 33 ± 7 to 48 ± 9 (P less then .0001) and the mean mental health score increased from 50 ± 13 to 54 ± 8 (P = .007). Mean active forward elevation increased from 97° ± 27° to 143° ± 25° (P less then .0001), and mean active external rotation increased from 21° ± 16° to 53° ± 18° (P less then .0001). Kaplan-Meier analysis showed an implant survivorship rate of 98% at 2 years. The composite clinical success rate was 87% compared with 85% for the stemmed control. Conclusions This study showed that a stemless rough-blasted humeral implant with metaphyseal bone fixation provides good clinical and radiographic outcomes and survivorship at 2 years, with outcomes comparable to a traditional stemmed implant.Background Secondary frozen shoulder after traumatic anterior shoulder instability is rare. The therapeutic management and clinical outcome of this condition are not well known. This study aimed to investigate the characteristics of such rare cases and verify treatment outcomes. Methods We reviewed the cases of 12 patients with secondary frozen shoulder after anterior shoulder dislocation or subluxation between April 2007 and March 2018. All patients underwent physical therapy along with an intra-articular injection. Patients with refractory stiffness received arthroscopic mobilization. The range of motion, Rowe score, and University of California, Los Angeles score were evaluated at the first and final visits. A telephone survey was performed to determine the long-term outcomes including recurrent instability, the Oxford Shoulder Score, and the Oxford Instability Score. Results The mean age of patients at the first visit was 42.5 years. Two patients underwent surgical treatment, which revealed scar-like tissue of the anteroinferior capsule.
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