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47, 95% CI [.25,.65]). GR and CRI-HT-S did not correlate (ρ=.09, 95% CI [-.16,.34]).
With excellent reliability and adequate validity, the quality of the GR as assessment instrument for communication skills could be demonstrated.
The GR is a suitable instrument for video-based rating of communication skills.
The GR is a suitable instrument for video-based rating of communication skills.
To define and compare gender diversity among faculty and trainees within hand surgery fellowship programs.
We determined the gender of each program director for all orthopedic residency and fellowship programs. Specific to hand fellowship programs, we determined the gender of the fellowship director and all faculty members for all plastic surgery and orthopedic hand fellowship programs. Lists of prior hand surgery fellows from 2014 to 2019 were obtained from official program websites or program coordinators. The gender distribution of the hand fellowship program directors and faculty was compared to the prior fellows.
Hand surgery fellowship programs had the second highest percentage of female fellowship directors (13%) behind orthopedic oncology (27%). Within hand surgery, 614 total faculty positions were identified, and 15% were female. Of the 89 hand surgery programs evaluated, 36 (60%) had at least 1 female faculty member. For the 849 prior fellows identified, 213 (25%) were female, and 79% of prograle applicants, and further study into recruiting qualified female candidates should be encouraged.
The aim of this study was to identify psychological factors associated with pain intensity and disability following distal radius fracture.
We prospectively followed 216 adult patients with distal radius fracture for 9 months. Demographics, injury and treatment details, and psychological measures (Hospital Anxiety and Depression Score [HADS], Pain Catastrophizing Scale, Posttraumatic Stress Disorder Checklist-Civilian, Tampa Scale for Kinesiophobia, Illness Perception Questionnaire Brief [IPQB], General Self-Efficacy Scale, and Recovery Locus of Control [RLOC]) were collected at enrollment. Multivariable linear regression was used to identify factors associated with Disabilities of the Arm, Shoulder, and Hand Questionnaire (DASH) and Likert pain scores.
Higher 10-week DASH scores were associated with increased age, the presence of a nerve pathology, increased HADS Depression subscale scores, increased IPQB scores, and lower RLOC scores. Higher 9-month DASH scores were associated with increased age, increased deprivation scores, increased numbers of medical comorbidities, a greater degree of radial shortening, increased HADS Depression subscale scores, and lower RLOC scores. A higher 10-week pain score was associated with increased deprivation and IPQB scores. A higher pain score at 9 months was associated with an increased number of medical comorbidities.
Psychosocial factors measured early after fracture are associated with pain and disability up to 9 months after distal radius fracture. Illness perception is a potentially modifiable psychological construct not previously studied in hand conditions. It may provide a suitable target for psychological interventions that could enhance recovery.
Prognostic II.
Prognostic II.
The purpose of this study was to describe a technique of end-to-end rigid fixation of the distal radius to the proximal ulna. The shortening and radioulnar overlap in this technique yield a high union rate, large corrections, and few complications.
This retrospective chart review from 2 centers was undertaken in 39 patients (40 forearms) who underwent one-bone forearm operations between 2005 and 2019. There were 25 male and 14 female patients, with a mean age at surgery of 9.7 years (range 3 to 19 years; SD, 4.5 years). The diagnoses included brachial plexus birth injury, spinal cord injury, arthrogryposis multiplex congenita, cerebral palsy, ulnar deficiency with focal indentation, multiple hereditary exostosis, acute flaccid myelitis, and tumor.
The average follow-up was 33.5 months (1.2-110.1 months; SD, 27.1 months). The 36 forearms in supination had an average supination contracture of 93° (range, 15° to 120°; SD, 15.4°). The 4 pronated arms had an average pronation contracture of 80° (range, 50° to 120°; SD, 29.2°). The average postoperative position was 22.8° of pronation (range, -15° to45°; SD, 12.9°). The average correction obtained with our technique was 113° (range, 20° to 145°; SD, 22.9°). Radiographic union was demonstrated in 32 (80%) of the one-bone forearms by 10 weeks, 39 (97.5%) by 16 weeks, and 40 (100%) by 24 weeks. One patient had peri-implant fractures prior to union. No forearms required reoperation for nonunion.
One-bone forearm performed with this technique allows reliable healing and a large degree of correction.
Therapeutic IV.
Therapeutic IV.
Hip length discrepancy (HLD) is common after total hip arthroplasty (THA); however, the effect of spinal fusion on perceived leg length discrepancy (LLD) symptoms after THA has not been examined. This study tested the hypothesis that LLD symptoms are increased in patients who underwent lumbar spinal fusion and THA, compared with patients with THA only.
This retrospective cohort study included 67 patients who underwent lumbar spinal fusion and THA, along with 78 matched control patients who underwent THA only. Hip and spine measurements were taken on postoperative, standing anterior-posterior pelvic, lateral lumbar, and anterior-posterior lumbar spinal radiographs. Perceived LLD symptoms were assessed via telephone survey.
Between the spinal fusion and control groups, there was no significant difference in HLD (M= 7.10 mm, SE= 0.70 and M= 5.60 mm, SE= 0.49) (P= .403). The spinal fusion patients reported more frequently noticing a difference in the length of their legs than the control group (P= .046) andpatients with prior spinal fusion, precautions should be taken to avoid even minor LLD in the setting of THA.
To describe out-of-hospital ketamine use, patient outcomes, and the potential contribution of ketamine to patient death.
We retrospectively evaluated consecutive occurrences of out-of-hospital ketamine administration from January 1, 2019 to December 31, 2019 reported to the national ESO Data Collaborative (Austin, TX), a consortium of 1,322 emergency medical service agencies distributed throughout the United States. We descriptively assessed indications for ketamine administration, dosing, route, transport disposition, hypoxia, hypercapnia, and mortality. We reviewed cases involving patient death to determine whether ketamine could be excluded as a potential contributing factor.
Indications for out-of-hospital ketamine administrations in our 11,291 patients were trauma/pain (49%; n=5,575), altered mental status/behavioral indications (34%; n=3,795), cardiovascular/pulmonary indications (13%; n=1,454), seizure (2%; n=248), and other (2%; n=219). The highest median dose was for altered mental status/behavas rare. Ketamine could not be ruled out as a contributing factor in 8 deaths, representing 0.07% of those who received ketamine.The use of 17 β-estradiol and genistein in women with menopause helps in the reduction of vasomotor symptoms and cognitive improvement. There is evidence on the use of certain flavonoids such as genistein, which has a potentially neuroprotective role in neurodegenerative diseases such as Alzheimer's. Scientific evidence on the effects of phytoestrogens and genistein during menopause and their effect on cognition are scarce, however, in the present review it was found that the intervention with 17 β-estradiol has positive effects on cognition in women with Alzheimer's disease. In addition, the use of genistein, daidzein or any supplement based on isoflavones may influence vasomotor symptoms. 17 β-estradiol supplements in women in early menopause and with some degree of cognitive impairment may have beneficial effects.
The multicomponent exercise program must be carried out in phases, due to the low tolerance of the old adults to prolonged efforts, since their functional reserve is reduced. The aim of study is investigate the effects of Multicomponent on Progressive Phases Program on functional capacity, fitness, quality of life, dual-task and physiological variables in the elderly.
This is a randomized controlled trial protocol with blind examiners. The protocol was registered at clinictrials.gov (protocol number NCT04118478). The experimental group will participate in a progressive multi-component program of 27 weeks divided into 3 phases of 9 weeks each of them. Primary outcomes will be determined by evaluating functional capacity using the Short Physical Performance Battery (SPPB), gait speed, and Time up and Go test. Fitness will be determined by the handgrip, 2-min step test, chair sit and reach test, and back scratch test. Quality of life will appear with the SF-36 questionnaire and dual-task with the walking-while-talking test. The physiological variables evaluated will be heart rate and blood pressure at rest, autonomic balance and forced spirometry. Secondary outcomes are determined by measuring the level of physical activity, motivation for exercise, and anthropometric variables.
The results derived from this research will increase the knowledge about the effects of a program of this type. The possible discoveries could serve as a guide to encourage future researchers to develop similar protocols. The purpose of the program is to serve as a practical and viable tool for the benefit of older people. Clinical trial registry protocol NCT04118478.
The results derived from this research will increase the knowledge about the effects of a program of this type. The possible discoveries could serve as a guide to encourage future researchers to develop similar protocols. The purpose of the program is to serve as a practical and viable tool for the benefit of older people. Clinical trial registry protocol NCT04118478.Chemotherapy resistance remains to be the primary barrier to acute myeloid leukemia (AML) treatment failure. Nuclear factor-erythroid 2-related factor 2 (Nrf2) has been well established as a truly pleiotropic transcription factor. Inhibition of Nrf2 function increases the sensitivity of various chemotherapeutics and overcomes chemoresistance effectively. Brusatol (Bru) has been reported to decrease Nrf2 protein expression specifically by ubiquitin degradation of Nrf2. However, it remains elusive whether combination of Brusatol and Cytarabine (Ara-C) elicits a synergistic antitumor effect in AML. Our results demonstrated that combination of Ara-C and Brusatol synergistically exerted remarkable pro-apoptosis effect in HL-60 and THP-1 cells. Mechanistically, synergistic anti-tumor effect of Ara-C/Brusatol in AML cells is mediated by attenuating Nrf2 expression. To our surprise, Nrf2 inhibition by Brusatol causes downregulation of the expression of glycolysis-related proteins and decreased glucose consumption and lactate production, whereas the level of ROS production was unaffected. The activation of Nrf2 by Sulforaphane (SFP) could reverse the chemotherapeutic effect and changes of glycolysis of concomitant of Ara-C with Brusatol in AML cell lines. Additionally, Ara-C/Brusatol co-treatment decreased Glucose-6-phosphate dehydrogenase (G6PD) protein expression and increased the sensitivity of Ara-C. read more Moreover, the mouse xenograft in vivo experiment confirmed that combining Ara-C with Brusatol exerted stronger antileukemia than Ara-C alone. The efficacy, together with the mechanistic observations, reveals the potential of simultaneously giving these two drugs and provides a rational basis for targeting glucose catabolism in future clinical therapeutic approach.
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