Health Survey Scores Research Articles

Clinical Effect of Modified Shengyang Yiwei Decoction in the Treatment of Diarrhea-Predominant Irritable Bowel Syndrome due to Spleen and Stomach Weakness

Objective: To explore the therapeutic effect of Shengyang Yiwei Decoction in patients with diarrhea-predominant irritable bowel syndrome (IBS) due to spleen and stomach weakness. Methods: 40 patients with diarrhea-predominant IBS who were treated from April 2018 to April 2020 were taken as samples. TCM (traditional Chinese medicine) syndrome differentiation found that they were all due to spleen and stomach weakness. They were randomly divided into two groups. Group A was treated with modified prescriptions of Shengyang Yiwei Decoction, while Group B was treated with Western medicine. The therapeutic effects in the two groups were compared. Results: The treatment efficacy in Group A was higher than that in Group B (P < 0.05); the symptom scores of Group A such as loose stools, chills, physical weakness, poor appetite, and abdominal distension after meals were all lower than those in Group B (P< 0.05); the SF-36 (36-Item Short Form Health Survey) scores of patients with diarrhea-predominant IBS in Group A were higher than those in Group B (P < 0.05); the treatment satisfaction of Group A was higher than that of Group B (P< 0.05). Conclusion: Treatment of diarrhea-predominant IBS patients with spleen and stomach weakness by Shengyang Yiwei Decoction can promote the disappearance of gastrointestinal discomfort symptoms, improve the quality of life, and enhance treatment efficacy. Hence, it is an efficient and feasible treatment for diarrhea-predominant IBS due to spleen and stomach weakness.

A multicenter, randomized controlled trial comparing a second-generation uncemented trabecular metal-backed vs. cemented polyethylene glenoid component in total shoulder arthroplasty: 5-year results

Previously, we reported early (2-year) findings from a randomized controlled trial comparing a second-generation uncemented trabecular metal-backed (TM) glenoid vs. cemented polyethylene glenoid (POLY) in patients undergoing a total shoulder arthroplasty. The purpose of the current study is to report disease-specific quality of life, clinical, patient-reported, and radiographic outcomes at midterm (5-year) from this trial. Five surgeons from 3 centers participated. Patients 18-79 years with a primary diagnosis of glenohumeral osteoarthritis were screened for eligibility. Randomization to an uncemented TM or cemented POLY glenoid was performed intra-operatively after adequate bone stock was confirmed. Study intervals were baseline, 2- and 5-year postoperative. The primary outcome was the Western Ontario Osteoarthritis Shoulder (WOOS) quality of life score. Secondary outcomes included the American Shoulder and Elbow Surgeons Standardized Shoulder Assessment Form, EuroQol-5 Dimensions, and 12-Item Short Form Health Survey scores and clinical and radiographic examinations. Radiographic images were reviewed for metal debris according to Endrizzi. Mixed effects repeated measures analysis of variance for within- and between-group comparisons were performed. Of the 104 patients who consented, 93 were randomized (46 TM; 47 POLY). There were no differences between groups at baseline (TM: mean age 66.5 years [standard deviation (SD) 6.4], 24 male and 22 female; and POLY: mean age 68.4 years [SD 5.5], 23 male / 24 female). Mean (SD) WOOS scores at baseline and 2 and 5 years were as follows: TM, 32 (21), 92 (13), and 93 (11); POLY, 27 (15), 93 (11), and 93 (10), respectively. No statistical or clinically relevant differences were noted with patient-reported outcomes between groups. Metal debris was observed in 11 (23.9%) patients, but outcomes were not negatively impacted, and debris severity was minor (grades 1 and 2). Complication rates were similar between groups (TM: 7 of 46 [15.2%], and POLY: 8 of 47 [17.0%]; P=.813). No aseptic glenoid failures were reported, but 1 patient in the TM group required revision because of infection. Our short-term (2-year) findings were maintained with longer follow-up. At 5 years postoperation, there were no statistically or clinically significant differences between an uncemented second-generation TM glenoid and a cemented polyethylene glenoid with respect to disease-specific quality of life or patient-reported outcomes. No glenoid implant failures were reported, and complication rates were similar between groups. Only one complication was glenoid related (1 infection in the TM group). Metal debris was observed in 23.9% of patients with a TM glenoid but did not negatively influence implant survival, patient-reported outcomes, or shoulder function.

Treatment of cartilage defects in the patellofemoral joint with matrix-associated autologous chondrocyte implantation effectively improves pain, function, and radiological outcomes after 5-7 years.

The aim of the present study was to evaluate midterm outcomes 5-7years after matrix-associated autologous chondrocyte implantation (MACI) in the patellofemoral joint. Twenty-six patients who had undergone MACI using the Novocart® 3D scaffold were prospectively evaluated. Clinical outcomes were determined by measuring the 36-Item Short-Form Health Survey (SF-36) and International Knee Documentation Committee (IKDC) scores and the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) values preoperatively and 3, 6, and 12months, and a mean of 6years postoperatively. At the final follow-up, the Magnetic Resonance Observation of Cartilage Repair Tissue (MOCART) score was evaluated. Twenty-two patients with 23 focal cartilage defects (19 patella and four trochlea) were available for the final follow-up. The mean defect size was 4.0 ± 1.9 cm2 (range 2.4-9.4 cm2). All clinical outcome scores improved significantly until 5-7 years after MACI (SF-36 score, 61.2 ± 19.6 to 83.2 ± 11.6; P = 0.001; IKDC score, 47.5 ± 20.6 to 74.7 ± 15.5; P < 0.001; and WOMAC, 29.8 ± 15.7 to 8.2 ± 10.3; P < 0.001). The mean MOCART score was 76.0 ± 11.0 at the final follow-up. Nineteen of the 22 patients (86.4%) were satisfied with the outcomes after 5-7 years and responded that they would undergo the procedure again. MACI in the patellofemoral joint demonstrated good midterm clinical results with a significant reduction in pain, improvement in function, and high patient satisfaction. These clinical findings are supported by radiological evidence from MOCART scores. IV-case series.

Effectiveness and mechanism of action of rTMS combined with quadriceps strength training in individuals with knee osteoarthritis: study protocol for a randomized controlled trial

BackgroundQuadriceps training is necessary in function and activity of daily living for patients with knee osteoarthritis (KOA). However, it did not reduce the rate of surgical treatment for end-stage KOA in the long term. This may be related to brain structure changes and maladaptive plasticity in KOA patients. Transcranial Magnetic Stimulation (TMS) could enhance the functional connectivity of brain regions and improves maladaptive plasticity. However, the synergistic effect of the combination of the two for treat KOA is still unclear. Therefore, the purpose of this study is to investigate whether the High-Frequency rTMS combined with quadriceps strength training can improve the pain and function in KOA more effectively than quadriceps training alone and explore the mechanism of action.MethodsThis study is an assessor-blind, sham-controlled, randomized controlled trial involving 12 weeks of intervention and 6 months follow-up. 148 participants with KOA will receive usual care management and be randomized into four subgroups equally, including quadriceps strength training, high-frequency rTMS training, sham rTMS and quadriceps strength training, high-frequency rTMS and quadriceps strength training. The rehabilitation interventions will be carried out 5 days per week for a total of 12 weeks. All outcomes will be measured at baseline, 4 weeks, 8 weeks, and 12 weeks during the intervention and 1 month, 3 months and 6 months during the follow-up period. The effectiveness outcomes will be included visual analog scale, isokinetic knee muscle strength, Knee Injury and Osteoarthritis Outcome score and 36-Item Short-Form Health Survey score; The act mechanism outcomes will be included motor evoked potential, grey matter density, white matter, subcortical nuclei volumes, cortical thickness and functional connectivity by MRI. Two-way of variance with repeated measures will be used to test the group and time effect for outcome measures.DiscussionThe study will be the first protocol to examine whether there are synergistic effects following high-frequency rTMS combined with quadriceps strength training for treat KOA and clarify the mechanism of action. High-frequency rTMS can be added into the training program for KOA patients if it is proven effective.Trial registrationChinese Clinical Trial Registry ChiCTR2300067617. Registered on Jan.13,2023.

Functional and Radiographic Outcomes of Open Proximal Femoral Fractures Caused by Gunshot Wounds in Yemen: A Prospective Cohort Study.

Open proximal femoral fractures caused by gunshot wounds are rare but devastating injuries that pose considerable challenges for prognosis and management. The aim of this study was to evaluate the functional and radiographic outcomes of patients with open proximal femoral fractures caused by gunshot wounds treated at 3 Level-I trauma centers in Yemen and to identify the factors that influence them. We prospectively enrolled 174 patients with open proximal femoral fractures caused by gunshot wounds. The fractures were classified according to the Gustilo-Anderson and OTA/AO systems. The primary outcome measures were fracture union, infection, and functional outcomes. The secondary outcome measures were the Harris hip score (HHS) and the Short Form-36 (SF-36) health survey score. We performed multivariable logistic regression modeling to identify the predictors of complications and poor functional outcomes. The overall rate of fracture union was 87%. The complication rates were 18% for infection, 13% for nonunion, 23% for reoperation, 12% for delayed union, 4% for osteonecrosis, 6% for heterotopic ossification, and 2% for amputation. The mean HHS at the final follow-up was 78.4, and the mean SF-36 score was 67.3. Open proximal femoral fractures caused by gunshot wounds are associated with high rates of complications and poor functional outcomes in Yemen. Early debridement, appropriate fixation, infection control, and adequate soft-tissue coverage are essential for achieving satisfactory results. The type of wound, the type of fracture, and the type of definitive fixation are significant predictors of the outcomes. Future studies should compare different fixation methods and evaluate the long-term outcomes and complications of these injuries. Therapeutic Level II. See Instructions for Authors for a complete description of levels of evidence.

Analysis of relevant influencing factors for recurrent urinary tract infections in children: exploring predictive factors and intervention measures.

To analyze the factors influencing recurrent urinary tract infections (UTIs) in children and explore predictive factors and intervention measures. Data of 158 children with UTIs treated at the Longyan First Affiliated Hospital of Fujian Medical University from January 2020 to June 2023 were analyzed. Among them, 122 children without recurrent UTIs were included in a non-recurrent group, while the remaining 36 were included in a recurrent group. The quality of life prior to treatment and six weeks after treatment, the immunoglobulin A (IgA) and immunoglobulin G (IgG) levels after treatment, the relationship between the quality of life after six weeks of treatment and the levels of IgA and IgG were analyzed. Multivariate logistic regression analysis was conducted to identify factors impacting the recurrence of UTIs, and receiver operating characteristic (ROC) curves were generated to predict recurrent UTIs based on independent risk factors. Before treatment, no notable difference was observed in Short Form 36 Health Survey (SF-36) scores between the non-recurrent group and the recurrent group (P>0.05). After treatment, the SF-36 scores notably increased in the non-recurrent group (P<0.0001), while there was no notable increase in the recurrent group (P>0.05). However, the difference in SF-36 scores after treatment was significant between the two groups (P<0.0001). In addition, there was a significantly positive correlation between IgA levels and quality of life after 6 weeks of treatment (P<0.05). The recurrent group showed significantly lower IgA and IgG levels than the non-recurrent group (P<0.05). Multivariate logistic regression analysis identified anemia, urinary system malformation, constipation, decreased IgA level, and decreased IgG level as independent risk factors for recurrent UTIs in children. ROC curves-based analysis of independent risk factors demonstrated that urinary system malformation had a better performance in predicting recurrent UTIs in children than the other four factors. Urinary system malformation, constipation, anemia, decreased IgA and IgG levels are all identified as independent risk factors for recurrent UTIs in children, and urinary system malformation is a better predictor for recurrent UTIs in children than the other four factors.

Isolated Talonavicular Arthrodesis as Treatment for Flexible Progressive Collapsing Foot Deformity: A Case Series.

For the younger, more active patient with flexible symptomatic progressive collapsing foot deformity (PCFD), joint-sparing procedures may be preferred to preserve functional motion. Isolated talonavicular (TN) arthrodesis has been described for treatment of rigid and flexible PCFD for patients that are older and less active whose deformity is still correctable through the TN joint. The purpose of this study was to evaluate radiographic and clinical outcomes in patients with PCFD treated with isolated triplanar correction with a TN joint arthrodesis. Forty-nine patients (53 feet) with flexible PCFD underwent isolated TN arthrodesis. Weightbearing radiographs were performed pre- and postoperatively, and measurements included lateral talar-first metatarsal angle, calcaneal pitch, TN coverage angle, and the anteroposterior (AP) talar-first metatarsal angle. The Foot and Ankle Ability Measure (FAAM) and Veterans-Rand 12-Item Health Survey (VR-12) scores were also collected. Thirty-five females and 14 males were evaluated with a mean age of 63 years, at an average follow-up of 41.3 months. Significant improvements were found radiographically. Lateral radiographs demonstrated improvements in lateral talar-first metatarsal angle from 25.2 degrees preoperatively to 9.5 degrees postoperatively (P < .001) and calcaneal pitch from 14.9 degrees preoperatively to 17.5 degrees postoperatively (P < .001). AP radiographs showed the TN coverage angle improving from 35.0 degrees to 4.9 degrees postoperatively (P < .001) and AP talar-first metatarsal angle improving from 17.3 degrees to 5.9 degrees postoperatively (P < .001). Clinical outcomes were improved in the FAAM pain score (48.6 to 39.2, P = .130), FAAM ADL score (53.8 to 69.2, P = .002), FAAM Sport score (29.5 to 40.7, P = .099), and the overall FAAM score (47.7 to 63.1, P = .006). Patient satisfaction with medical care was 85.2/100 postoperatively. Isolated TN arthrodesis is a viable surgical option for older, lower-demand patients with flexible PCFD. This study demonstrated significant improvements in radiographic alignment and FAAM scores. Comparative studies with other surgical procedures should be performed to determine which is the best technique for older, lower-demand patients with flexible PCFD. Level III, retrospective cohort study.

Is trans-sacral endoscopic laser decompression truly effective? Clinical and functional assessment of a single spine center.

Herniated nucleus pulposus (HNP), without causing significant neurological deficit, is a more frequently occurring disease of the spine affecting the activities of daily living with chronic back pain and sometimes progressing to produce significant functional deficit. Trans-sacral epiduroscopic laser decompression (SELD) is being increasingly used as a treatment modality for these conditions and has been shown to give effective results. We present the clinical outcomes of the patients undergoing SELD in our institute for HNP. A retrospective study of 411 patients who underwent SELD for lumbar disc herniation was done, analyzing the clinical outcomes by measuring visual analog scale (VAS) scores for leg pain and back pain, Oswestry Disability Index (ODI) score, and Short form health survey (SF -36) scores and followed up for 6 months. A total of 195 males and 216 females underwent SELD, with a mean age of 33.2 ± 0.9 years and a mean follow-up period of 7 ± 1.6 months. VAS scores for back pain and leg pain improved significantly from 6.9 ± 0.5 and 6.6 ± 0.6 preoperatively to 1.1 ± 0.5 (P > 0.05) and 0.4 ± 0.5 (P > 0.05) at 6 months. ODI score decreased from 28.2 ± 1.7 to 9.4 ± 1.7 at 6 months from the intervention (P < 0.05). SF-36 showed significant improvement in overall categories through 6 months of follow-up. Twenty-four patients had dural punctures, and four patients needed blood patches but recovered without any complications. One patient had aggravation of the disc herniation post-procedure, and was managed by endoscopic discectomy. SELD is a safe, accurate, and effective procedure in treating symptomatic lumbar disc herniation with excellent clinical outcomes and effective pain relief with minimal damage to paraspinal muscles with an easier learning curve, reproducible results, and high safety index.

Supportive Psychotherapy Combined with Analgesic Management can Effectively Improve Pain and Quality of Life in Patients with Advanced Prostate Cancer: A Retrospective Study.

Patients with advanced prostate cancer commonly experience psychological issues and have a low quality of life. This study aims to analyse the application of supportive psychotherapy combined with analgesic management on the pain and quality of life of patients with advanced prostate cancer. Patients with advanced prostate cancer admitted to our hospital from February 2018 to December 2022 were continuously selected as the research objects. In accordance with the different management methods recorded in the medical record system, the patients were divided into a control group (routine nursing + analgesic management) and an observation group (routine nursing + analgesic management + supportive psychotherapy). The Athens Insomnia Scale (AIS), State Anxiety Scale (S-AI), Trait Anxiety Scale (T-AI), Numeric Rating Scale (NRS) and 36-Item Short-Form Health Survey (SF-36) scores between the two groups were compared. A total of 125 patients with advanced prostate cancer participated in this study, with 60 patients in the control group and 65 patients in the observation group. No significant difference was found in the scores of the AIS, S-AI, T-AI, NRS and SF-36 of the two groups before management (p > 0.05). After management, the AIS (4.00 vs. 5.00, p = 0.002), S-AI (38.88 vs. 41.12, p = 0.002), T-AI (39.17 vs. 41.65, p = 0.001) and NRS (3.00 vs. 3.00, p < 0.001) scores of the observation group were lower than those of the control group. However, the SF-36 scores of the observation group were higher than those of the control group in the dimensions of physiological enginery (75.85 vs. 68.75, p < 0.001), physiological function (71.85 vs. 67.75, p = 0.004), body pain (73.15 vs. 69.33, p = 0.006), social function (73.88 vs. 69.85, p = 0.004), emotional function (72.92 vs. 68.98, p = 0.006), mental health (73.52 vs. 69.83, p = 0.008), vitality (72.09 vs. 69.52, p = 0.044) and general health (70.65 vs. 66.23, p = 0.002). Supportive psychotherapy combined with analgesic management for patients with advanced prostate cancer may help improve the pain, anxiety and quality of sleep and life of patients.

Outcome of Open Reduction and Internal Fixation versus Hemiarthroplasty in Proximal Humerus Complex Fractures

Abstract Background: This study compares open reduction and internal fixation (ORIF) versus hemiarthroplasty (HA) in the management of complex proximal humerus fractures. Materials and Methods: Neer three- and four-part fracture-dislocations, surgical neck fracture-dislocations with severe articular impaction, and any head-split fracture treated surgically at our institution were studied retrospectively. Constant–Murley scores, Disability of the Arm, Shoulder, and Hand (DASH), American Shoulder and Elbow Surgeons (ASES) Shoulder, and 36-item Short-Form Health Survey (SF-36) scores were obtained and compared between ORIF versus HA treatment. Results: Thirty patients were included in the analysis: 15 treated with ORIF were compared to 15 treated with HA with an average follow-up of 60 months. The mean Constant score (72 ± 15 vs. 54 ± 19; P = 0.005), DASH score (13 ± 17 vs. 29 ± 18; P = 0.006), ASES score (87 ± 13 vs. 66 ± 22; P = 0.003), and SF-36 physical composite score (PCS) (50 ± 11 vs. 40 ± 11; P = 0.02) all favored the ORIF group. Because of the potential confounding variable posed by including younger patients, we performed a subgroup analysis of patients older than 50 years. In this group, the Constant, DASH, ASES, and PCS scores remained significantly better in the ORIF group. Conclusion: Results of this retrospective study show improved patient-reported outcomes and quality of life scores in patients undergoing ORIF for complex proximal humerus fractures as compared to patients undergoing HA, despite a higher revision rate in the ORIF cohort. When considering patients older than 50 years, outcomes after ORIF were better than HA.

The impact of metabolic syndrome on clinical outcomes following total knee arthroplasty in osteoarthritis patients.

Metabolic syndrome (MetS) is a combination of interconnected conditions, including insulin resistance, abdominal obesity, high blood pressure, and abnormal blood lipid levels. The objective of this research was to investigate the impact of MetS on the quality of life and clinical outcomes following total knee arthroplasty (TKA) in patients with osteoarthritis (OA). A retrospective descriptive study was conducted to enroll OA patients who underwent primary TKA at Zhongda Hospital, Southeast University from January 2015 to August 2019. A total of 83 OA patients who did and 144 (MetS group) who did not have MetS (non-MetS group) were included. An analysis was conducted on the patient's clinical data. The two groups had similar results in terms of lengths of stay (P=0.93), hospital costs (P=0.24), and overall complication rates (P=0.99). There was no significant difference in the average erythrocyte sedimentation rate and C-reactive protein levels between the groups. However, the MetS group exhibited notably lower Hospital for Special Surgery knee scores and Short Form [36] health survey (SF-36) scores compared to the non-MetS group (both P>0.05) during the one-year follow-up period. OA patients who have MetS had significantly worse knee joint function and quality of life after TKA. There are certain constraints in the current research. First, it belongs to a single-center retrospective study. Further study will be necessary to determine the generality of this conclusion. Second, this study is retrospective, and the number of patients included is not large. Third, due to the diverse clinical groups in our hospital, it is challenging to comprehensively document all the clinical data of the patients involved in this study. Forth, this study did not compare the preoperative differences between the two groups, as well as analyze the postoperative improvement changes in depth. We will compare the preoperative and postoperative differences between the two groups in more depth in future large sample studies.

Deep brain stimulation of the subthalamic nucleus for primary Meige syndrome: clinical outcomes and predictive factors.

Deep brain stimulation (DBS) of the subthalamic nucleus (STN) has demonstrated efficacy against multiple types of dystonia, but only a few case reports and small-sample studies have investigated the clinical utility of STN-DBS for Meige syndrome, a rare but distressing form of craniofacial dystonia. Furthermore, the effects of DBS on critical neuropsychological sequelae, such as depression and anxiety, are rarely examined. In this study, the authors investigated the therapeutic efficacy of STN-DBS for both motor and psychiatric symptoms of Meige syndrome. The authors retrospectively reviewed consecutive patients with Meige syndrome receiving bilateral STN-DBS at their institution from January 2016 to June 2023. Motor performance and nonmotor features including mood, cognitive function, and quality of life (QOL) were evaluated using standardized rating scales at baseline and at final postoperative follow-up. Clinical and demographic factors influencing postoperative motor outcome were evaluated by uni- and multivariable linear regression models. Fifty-one patients were ultimately included, with a mean ± SD follow-up duration of 27.3 ± 18.0 months. The mean Burke-Fahn-Marsden Dystonia Rating Scale (BFMDRS) movement score improved from 12.9 ± 5.2 before surgery to 5.3 ± 4.2 at the last follow-up (mean improvement 58.9%, p < 0.001) and the mean BFMDRS disability score improved from 5.6 ± 3.3 to 2.9 ± 2.9 (mean improvement 44.6%, p < 0.001). Hamilton Depression and Anxiety Rating Scale scores also improved by 35.3% and 34.2%, respectively, and the postoperative 36-item Short-Form Health Survey score indicated substantial QOL enhancement. Global cognition remained stable after treatment. Multiple linear regression analysis identified disease duration (β = -0.241, p = 0.027), preoperative anxiety severity (β = -0.386, p = 0.001), and volume of activated tissue within the dorsolateral (sensorimotor) STN (β = 0.483, p < 0.001) as independent predictors of motor outcome. These findings support STN-DBS as an effective and promising therapy for both motor and nonmotor symptoms of Meige syndrome. Timely diagnosis, treatment of preoperative anxiety, and precise electrode placement within the dorsolateral STN are essential for optimal clinical outcome.

Application of a Quality Control Circle Method in Reducing the Incidence Rate of Vasovagal Reflex in Patients Treated with Vascular Intervention Surgery

Objectives: In this paper, we discuss the effect of a quality control circle (QCC) method on reducing the incidence rate of vasovagal reflex (VVR) in patients treated with vascular intervention surgery. Methods:We selected 190 patients treated with vascular intervention surgery at Yantai Yuhuangding Hospital (Yantai City, Shandong Province) from January 22, 2021 to February 24, 2023. A random number table was used to divide these patients into a research group (N=95) and a control group (N=95. We compared multiple indices between the 2 groups. Results: The incidence rate of VVR in the research group was lower than in the control group (10.53% vs 22.11%, χ2 = 4.664, p &lt; .05). The comparison results of physical status between the 2 groups showed that the heart rate (83.00 ± 5.00 vs 67.00 ± 5.00), systolic blood pressure (123.36 ± 11.42 vs 112.36 ± 10.31), diastolic blood pressure (81.32 ± 9.76 vs 64.81 ± 8.94), urinary dysfunction (19 vs 41), abdominal discomfort (14 vs 34), defecation desire (11 vs 32), and health survey (65.37±9.52 vs 57±9.88) scores of the research group were greater than those of the control group (p &lt; .05). The depression and anxiety levels, degree of compliance with medical orders and level of satisfaction in the research group were greater than in the control group (p &lt; .05). Conclusions: The application of QCC will significantly reduce the incidence rate of VVR in patients treated with vascular intervention surgery, enhance communication and cooperation with patients, improve therapeutic efficiency, prevent surgical risks, and ensure safety.

Effect of an Internet-Hospital-Community-Home Linked Health Management Model in Patients with Osteoporotic Vertebral Compression Fractures Who Received Conservative Treatment: A Quasi-Experimental Study

Objective: To evaluate the effect of an internet-hospital-community-home (IHCH) linked health management model in the management of patients with osteoporotic vertebral compression fractures (OVCF) who undergoing conservative treatment. Methods: This quasi-experimental study enrolled patients with OVCF who undergoing conservative treatment and visited to xx hospital between April 2022 and September 2022. Patients were divided into two group based on their time of visit to receive the IHCH linked health management (IHCH group) or routine management (control group). The outcomes were activities of daily living (ADL) scores, quality of life [measured by SF-36 Health Survey (SF36) scores], functional disability [measured by Roland-Morris Disability Questionnair (RMDQ) score], pain assessment [measured by Visual Analog Scale (VAS) score] at acute stage, 1 month, 3-month, 6 months after intervention; and pressure injuries, medication adherence, and health service satisfaction at 6 months after intervention. Results: Sixty-two patients completed the follow-up, with 31 cases in each group. The baseline information between the two groups were comparable (all P&gt;0.05). After intervention, repeated measures ANOVA showed that the ADL (P time &lt; 0.001, P group = 0.045, P time x group &lt; 0.001), SF-36 (P time &lt; 0.001, P group = 0.008, P time x group &lt; 0.001), and RMDQ scores (P time &lt; 0.001, P group = 0.014, P time x group &lt; 0.001) in IHCH group were significantly improved compared to the control group, which were interacted with time. Furthermore, at the 6-month follow-up, the IHCH group exhibited significantly lower incidence of pressure injuries [2 (6.67) vs 8 (26.67), P = 0.038], higher medication adherence [16 (53.33) vs 9(30.00), P = 0.031], and greater satisfaction with health services [Total satisfaction: 27 (90.00) vs 19 (63.33), P = 0.015] compared to the control group. Conclusion: The IHCH linked health management model might improve the effectiveness of conservative treatment for OVCF patients, reduce the occurrence of complications, and enhance satisfaction with health services.

Effects of Total Hip Replacement and Femoral Head Replacement in the Treatment of Femoral Neck Fractures in Elderly Patients and Their Impacts on Hip Joint Function

Objective: To explore the therapeutic value of total hip replacement and femoral head replacement in elderly patients with femoral neck fractures. Methods: 30 elderly patients with femoral neck fractures were sampled from January 2019 to August 2023 and randomly divided into two groups. Total hip replacement was adopted in the research group, and femoral head replacement was performed in the control group. The surgical indicators, quality of life, hip replacement, Harris hip score, and surgical complications were compared between the groups. Results: The operation time of the research group was longer than that of the control group, and the intraoperative blood loss and postoperative drainage volume were higher than those of the control group, P &lt; 0.05; the SF-36 (36-Item Short Form Health Survey) score of the research group was higher than that of the control group, P &lt; 0.05; the Harris scores of various hip joints of the research group were higher than those in the control group, P &lt; 0.05; the femoral neck fracture complication rate in the research group was lower than that in the control group, P &lt; 0.05. Conclusion: Both total hip replacement and femoral head replacement can improve hip joint function in treating femoral neck fractures in elderly people. However, total hip replacement has better long-term efficacy and can enhance patients’ quality of life and reduce postoperative complications.

Impacts of Operating Room Refined Nursing on Orthopedic Surgery Patients

Objective: To explore the impacts of operating room refined nursing on orthopedic surgery patients. Methods:A sample of 62 orthopedic surgery patients admitted from March 2022 to March 2023 were randomly divided into two groups, with 31 patients each. Group A received operating room refined nursing while Group B received routine nursing. Emotion, pain, quality of nursing, quality of life, complications, and differences in nursing satisfaction were compared between the two groups. Results: The scores of Self-Rating Anxiety Scale (SAS), Self-Rating Depression Scale (SDS), and Visual Analogue Scale (VAS) of orthopedic surgery patients in Group A were all lower than those in Group B, P &lt; 0.05; the scores of each nursing quality index in Group A were higher than those in Group B, P &lt; 0.05; the SF-36 (36-Item Short Form Health Survey) scores of Group A were higher than Group B, P &lt; 0.05; the complication rate in Group A was lower than that in Group B, P &lt; 0.05; the nursing satisfaction in Group A was higher than that in Group B, P &lt; 0.05. Conclusion: Operating room refined nursing can reduce postoperative pain, soothe the emotions of orthopedic surgery patients, strengthen the quality of nursing, and reduce postoperative complications, which is efficient and feasible for clinical application.

Comparison of nerve versus tendon transfer for radial nerve palsy

ObjectiveThis study aims to investigate the choice of intervention time and operation mode between nerve and tendon transfer for the treatment of radial nerve palsy (RNP). Methods46 RNP patients underwent nerve transfer (n = 22) and tendon transfer (n = 24). The intraoperative blood loss, main incision length, operation duration, and length of hospital stay and follow-up period of patients in these two groups were recorded and compared. The range of motion (ROM) of the elbow, wrist, fingers, and thumb, the hand grip and pinch strength, the Disabilities of Arm, Shoulder, and Hand (DASH) and the 36-Item Short Form Health Survey (SF-36) scores were measured and compared preoperatively and postoperatively between the two groups. ResultsThe ROM of thumb and the hand grip strength of patients in the nerve transfer group were greater than that in the tendon transfer (P < 0.05). Both of the two groups indicated significant improvements in the ROM of elbow, wrist, finger, thumb and the hand grip and pinch strength (P < 0.05) postoperatively. The DASH scores decreased significantly at 6 months (P < 0.05) and 12 months (P < 0.05) after surgery in both groups, while the postoperative SF-36 scores significantly increased (P < 0.05). There was no significant difference in postoperative DASH and SF-36 scores between the two groups (P > 0.05). ConclusionIn summary, both nerve and tendon transfer techniques are effective treatments for RNP. Nerve transfer is particularly advantageous for early RNP, while tendon transfer is suitable for patients with radial nerve injury more than one year.

Health-related quality of life among adolescents and young adults with mood and anxiety concerns.

To characterize health related quality of life (HRQOL) for Canadians aged 16 to 25 (adolescents and young adults, AYAs) seeking care for mood and anxiety concerns at the First Episode Mood and Anxiety Program, in London, Ontario and to identify factors associated with HRQOL in this population. AYAs completed demographic, psychometric, and HRQOL questionnaires. We calculated 36-Item Short-Form Health Survey (SF-36) scores standardized to Canadian and US population norms. We computed Short Form 6 Dimension (SF-6D) utilities conducting multivariable linear regression analysis, adjusting for age, sex, ethnoracial minority status, parental marital/cohabitation status, parental education, the Anxiety Sensitivity Index (ASI-R), Montgomery-Åsberg Depression Rating Scale Self-Report (MADRS-S), Sheehan Disability Scale (SDS), and a modified Inventory of College Students' Recent Life Experiences (ICSRLE-M). Amongst 182 AYAs who completed questionnaires, mean physical component summary (PCS), mental component summary (MCS) and SF-6D utility scores were low, 43.8 (SD = 16.6), 19.0 (SD = 11.9) and .576 (SD = .074), respectively. Maternal post-secondary education, depression (MADRS-S) and functional impairment (SDS) were significantly associated with SF-6D utility. This cohort of mental healthcare-seeking AYAs had significantly impaired psychometric and utility-based measures of quality of life, underscoring the importance of timely access to healthcare services for this population.

Outcomes of Anterior Cruciate Ligament Reconstruction With Independently Tensioned Suture Tape Augmentation at 5-Year Follow-up

Background: Reconstruction using autograft remains the gold standard surgical treatment for anterior cruciate ligament (ACL) injuries. However, up to 10% to 15% of patients will suffer a graft failure in the future. Cadaveric studies have demonstrated that the addition of suture tape augmentation to ACL autograft constructs can increase graft strength and reduce elongation under cyclical loading. Purpose/Hypothesis: This study aimed to investigate the clinical outcomes and rerupture rates after ACL reconstruction (ACLR) with suture tape augmentation. We hypothesized that augmentation with suture tape would lead to lower rerupture rates. Study Design: Case series; Level of evidence, 4. Methods: Patients undergoing primary ACLR using hamstring or patellar tendon autografts augmented with suture tape between 2015 and 2019 were recruited prospectively. Patients with multiligament injuries or a concomitant lateral extra-articular procedure were excluded. Patients were observed in person for 6 months, and patient-reported outcome measures (PROMs) were collected at 2 and 5 years postoperatively. All patients were contacted, and records were reviewed to determine the incidence of graft failure. PROMs collected were as follows: Knee injury and Osteoarthritis Outcome Score (KOOS), Veterans RAND 12-Item Health Survey (VR-12), Tegner and Marx activity scores, and visual analog scale for pain (VAS). Results: A total of 97 patients, with a mean age of 34.7 (±13.4) years, were included (76% men; 52 hamstring and 45 patellar tendon grafts). The mean graft diameter was 8 (±1) mm. There was 1 rerupture (1.1%) out of the 90 patients who were contactable at a mean of 5 years postoperatively. Median KOOS scores at 2 years were as follows: Pain, 94; Symptoms, 86; Activities of Daily Living, 99; Sport and Recreation, 82; and Quality of Life, 81. The postoperative scores were significantly higher than the preoperative scores (P < .001). The VR-12 Physical score improved from 43 preoperatively to 55 at 2 years and remained at 56 at 5 years. The VAS pain, Tegner, and Marx scores were 0, 6, and 9, respectively, at 2 years postoperatively. There was no difference in PROMs between graft types. Conclusion: This study demonstrates encouraging results of suture tape augmentation of autograft ACLR for both hamstring and patellar tendon grafts. The failure rate of 1.1% at a mean follow-up of 5 years is lower than published rates for reconstruction, and PROMs results are satisfactory. The technique is safe to use and may permit a return to the preinjury sporting level with a lower chance of reinjury.

12-Year clinical and radiological results of a double-blind randomized controlled trial comparing posterior cruciate-retaining versus posterior-stabilized total knee arthroplasty

BackgroundA subject of ongoing debate among orthopedic surgeons is the importance of preserving the posterior cruciate ligament in total knee arthroplasty (TKA), but long-term survival studies are scarce. The aim of this study was to compare long-term survival rates, and clinical and radiological follow up of a double-blind randomized controlled trial comparing posterior cruciate-retaining (PCR) versus posterior-stabilizing (PS) implant design of an AGC TKA. MethodsA total of 114 patients were included in the survival analysis (PCR n = 61; PS n = 53). Forty-five patients (PCR n = 25; PS n = 20) participated in the long-term follow up using patient-reported outcome measures (Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), Short-Form Health Survey (SF-36) and Kujala score (measuring anterior knee pain)). Thirty-one patients were assessed with a physical test (Knee Society Score (KSS)) and radiographs. ResultsOverall survival rate was 95.6% (PCR 98.4% vs. PS 92.5%), with five patients having a major revision (PCR n = 1 vs. PS n = 4, respectively). Satisfying outcome scores for both groups were described at on average 12-year follow up with no significant differences in KSS knee and function scores, WOMAC, SF-36, or Kujala scores between groups. Radiographically, there were no findings of femoral or tibial loosening or polyethylene wear in either group. ConclusionsGood long-term survival rates were described for the PCR and the PS design of an AGC TKA. There were no significant differences in clinical and radiological outcomes between a PCR and a PS design 12 years postoperatively.