Wrist In Patients Research Articles

Results of tendon transfers for stabilization of wrist joints for patients with rheumatoid arthritis

Objectives. The high incidence of damage to small joints of the hand in rheumatoid arthritis (RA), leading to persistent disability, is an important problem in rheumatoidology. A common operation for arthrodesis of the wrist joint to correct emerging deformities is traumatic and limits the function of the hand. In recent years, at the V.A. Nasonova Research Institute of Rheumatology, it has been replaced by new soft tissue joint-saving operations, which allow maintaining good hand function and preventing the development of severe deformities in the future. Target. Comparison of the results of performing soft tissue stabilizing operations on transposition of the tendons of the long radial and ulnar extensor carpi and arthrodesis of the wrist joint in patients with RA. Methods. The study included 69 patients operated on at the V.A. Nasonova Federal State Budgetary Institution NIIR in the period from 2018 to 2023. 24 patients underwent transposition of the long radial and ulnar extensor carpi (transposition ECU + ECRL - extensor carpi ulnaris and extensor carpi radialis longus) with subsequent tenodesis. The control group consisted of 45 patients who underwent arthrodesis of the wrist joint. The DASH questionnaire was used to assess functional status before and after surgery. To assess quality of life - EQ-5D index, pain - VAS, disease activity was assessed using the DAS28 index. The average follow-up period for patients after surgery was 6 months. Results. The functional status of patients after surgery, assessed by the DASH scale, was significantly better in the group of patients who underwent transposition of the tendons of the long radial and extensor carpi ulnaris 39.41±10.17 compared to the control group of wrist arthrodesis 46.4±15.8 (p0.05). Conclusions: ECU+ECRL tendon transpositions are an effective method for stabilizing the wrist joints and correcting hand deformities, but they have a number of limitations, the most important of which is the degree of damage to the wrist joints and the severity of the deformities.

Is there an association between arteriovenous fistulas and axillary artery aneurysms? A report of two cases

IntroductionAxillary artery aneurysms are rare vascular conditions that can present with various clinical manifestations, including neurological deficits and vascular compromise. While the underlying pathophysiology remains complex and multifactorial, potential associations with trauma, arteriovenous fistula formation, and atherosclerosis have been reported.Presentation Of Case.Two male patients, aged 33 and 38, with a history of kidney transplantation and previous arteriovenous fistula (AVF) presented with symptoms of upper limb ischemia and neurological compromise. Imaging revealed large axillary artery aneurysms. Open surgical repair was performed for both cases. Two weeks after discharge, one patient showed good pronation and supination with mildly limited extension. The other patient's wrist drop gradually improved with physiotherapy. DiscussionMultifactorial pathophysiology encompassed altered blood flow dynamics, inflammation, and the underlying vascular pathology. Chief complaints and prior vascular interventions contributed. Open surgical repair was preferred to endovascular approaches, achieving favorable outcomes. ConclusionAxillary artery aneurysms in patients with a history of AVF are rare but potentially serious complications. The cases highlight the complexity of axillary artery aneurysms and the need for careful evaluation and surgical intervention This strategy is crucial to prevent potential complications and optimize patient outcomes. Further research is needed to elucidate the precise pathophysiology and the potential association between AVF and the subsequent development of axillary artery aneurysms. Increasing awareness among surgeons could enable earlier detection of aneurysms, thereby reducing the risk of complications.

Novel Approaches Needed: An Experimental Study with an Alternative to Mechanical Restraint.

Despite many calls to reduce or eliminate the use of mechanical restraint, it is still widely used in many countries. Studies using patient interviews have a very clear message: Patients experience mechanical restraint as the most humiliating intervention. There seems to be a lack of alternatives for violent patients if all other approaches to prevent the use of coercion have failed. We developed a method using 30 kg bags, originally designed for fitness purposes, to be attached to a patient's wrist or ankle under 1:1 supervision. The method was tested with 10 experienced nurses and de-escalation trainers. A video was made and presented to six outpatients who had previously experienced mechanical restraint. All participants were interviewed. Transcribed interviews were analysed using qualitative content analysis. All participants approved of the method as a milder and less humiliating alternative to mechanical restraint. The nurses' main concerns were the risk of falls and the use of the bags as weapons. The latter could be controlled by using an additional bag. Patients were generally positive, especially if there was a history of abuse. The method should be further developed to replace at least some mechanical restraints. As with all 'milder means', care should be taken to really replace restraint and not to introduce additional coercion.

A rare case of solitary exostosis of capitate

Exostosis arising from carpal bones is rare and only a few cases have been reported till date. A 29 years old female came to the outpatient department with a localized swelling present on the dorsum of her right wrist since the past three years. On examining the patient clinically, a well-defined protuberance was observed over the dorsal aspect of the right wrist. CT report showed bony outgrowth over the dorsum of the capitate extending beyond the carpometacarpal joint. In surgical intervention, the mass was removed from the base, which grossly had an appearance of chondral origin. The biopsy report confirmed the diagnosis of exostosis (osteochondroma). Hence, excising the exostosis surgically led to achievement of adequate motion of the patient's wrist along with the additional cosmetic correction benefit.

Monitoring SpO2, BPM, and Temperature on Smartband with Data Sending Using IoT Android Display

No matter if a patient is receiving care at home or in a hospital, monitoring them is an essential part of healthcare. Currently, many hospitals use a manual method to measure body temperature, oxygen saturation, and heart rate, necessitating physical visits from nurses to patients' rooms to get data. This approach, however, turns out to be less effective and time-consuming. This research aims to develop a wearable device placed on a patient's wrist is the main goal of this project. Body temperature, oxygen saturation, and heart rate are the three vital sign metrics that this gadget will be able to continuously monitor in real-time. Additionally, Ubidots integration will enable the device to deliver notifications based on the data gathered.The contribution of this research is the development of IoT-based wearable devices for remote monitoring, which aims to improve the quality of health service monitoring. The tool is expected to facilitate remote monitoring for medical personnel and patient families. This research method uses MAX30100 as digital sensors to monitor heart rate, oxygen saturation and MLX90614 as a sensor to detect body temperature. The results of this research can display data on the Ubidots application and send notifications to email. The results showed that the SpO2 sensor had the lowest error rate of 0.2% and the highest mistake rate of 1.6%. The error rates displayed by the BPM sensor varied, with the lowest being 0.6% and the largest being 5.68%. For body temperature measurements, the minimum error rate recorded is 0.002%, while the maximum error rate is 0.016%. This research shows that it is time to develop further into a sophisticated health monitoring tool to improve the quality of health services.

Nadifit: a novel single position pulse based diagnostic system

Both traditional Chinese medicine (TCM) and traditional ayurvedic medicine (TAM) rely on a system of radial pulse diagnostics to assess a patient's health. The doctor or practitioner should place all three fingers on the patient's wrist and feel the styloid processes to detect any changes in the radial pulse. However, finding medical professionals skilled in pulse diagnosis or nadipariksha is becoming increasingly challenging in the current and upcoming generation. One technological approach that could solve this issue once and for all would be to transform objective pulse diagnosis into a subjective process. To automate this procedure, however, three separate sensors must be constructed for three positions in order to capture pulse at varying pulse pressures, which increases the hardware complexity for consumer use. To simplify the process and ensure a correct diagnosis, this study presents an effort to create the smart portable system Nadifit, which takes a single pulse reading from the patient. A single pulse is all that's needed to identify distinctive organ patterns, which can then be analyzed to provide insight into potential health issues. Analogue signals are quantified with the help of a microphone, a transmitter, and a 32-bit microprocessor. The data is acquired with a precision of 10 bits and virtually no electronic or contaminating noise outside of the system. The computer receives the collected pulse signal and does time and frequency domain analysis of the Nadi patterns, shapes, and width to determine the presence of the three ayurveda doshas (Vata, pitta, and kapha) as well as Chinese organ patterns (such as Qi stagnation, yin deficiency, yang excess, etc.). The experimental results demonstrate the effectiveness of the suggested system in identifying dosha, making it highly tailored to the individual patient's health issue. It is also demonstrated that the pulse waveform demonstrates the desired fluctuations in relation to patient age, pressure applied to the sensing element and full vs. empty stomach. Comparisons of stiffness across age groups are also performed. Practitioners, vaidhyas, and medical professionals are used to verify the system's accuracy. Hence, we believe a larger segment of the general public will be able to make use of our technology.

Diagnostic performance of double inversion recovery MRI sequence for synovitis of the wrist joints in rheumatoid arthritis.

To assess the diagnostic accuracy of double inversion recovery (DIR) magnetic resonance imaging (MRI) sequences for synovitis of the wrist joints in patients with rheumatoid arthritis (RA). Participants with newly diagnosed RA were enrolled between November 2019 and November 2020. MRI examinations of the wrist joints were performed using a contrast-enhanced T1-weighted imaging sequence (CE-T1WI) and DIR sequence. We measured synovitis score, number of synovial areas, synovial volume, mean synovium-to-bone signal ratio (SBR), and synovial contrast-to-noise ratio (SNR). The inter-reviewer agreement rated on a four-point scale was evaluated by calculating the weighted k statistics. Two MRI sequences were assessed using Bland-Altman analyses, and the diagnostic performance of DIR images was calculated using the chi-square test. A total of 47 participants were evaluated, and 282 joint regions in 5076 images were reviewed by two readers. There was no significant difference in synovitis scores (P = 0.67), number of synovial areas (P = 0.89), and synovial volume (P = 0.086) between the two MRI sequences. DIR images showed better SBR and SNR (all P < 0.01). There was good agreement between the two reviewers in terms of synovitis distribution (κ = 0.79). The synovitis was well agreed upon by the two readers according to Bland-Altman analyses. Using CE-T1WI as the reference standard, DIR imaging demonstrated a sensitivity of 94.1% and a specificity of 84.6% at the patient level. The non-contrast DIR sequence showed good consistency with CE-T1WI and potential for evaluating synovitis in patients with RA.

Factors associated with subclinical inflammation of wrist joints in rheumatoid arthritis patients with low or no disease activity- a RA ultrasound registry study

BackgroundTo evaluate the factors to predict subclinical inflammation of wrist joints in patients with RA who are in clinical remission or low disease activity.MethodsGray scale and power Doppler ultrasound were performed on the dorsal radio-lunate of both wrists. The presence of synovitis, comorbidities, and use of disease modifying anti-rheumatic drugs were recorded. A Multivariable forward logistical regression model was used to identify factors associated with subclinical inflammation.ResultsThere were 1248 patients (1010 females, 238 males; mean age: 60.0 ± 10.5 years ). 57.4% of patients in complete remission and low disease activity had sonographic inflammation. Multivariable forward logistic regression analysis indicated that male sex, smoking are positively associated with inflammation and that age, alcohol consumption, and use of methotrexate, glucocorticoid, or a biological therapy are negatively associated with inflammation. Use of biological agents decreased the risk of inflammation by 40.9%.ConclusionsThere was evidence of subclinical inflammation in most patients who were in low or no disease activity, those with biological therapy had lower risk of subclinical inflammation.

Optical spectral transmission to assess glucocorticoid therapy response in patients with arthritis: a longitudinal follow-up comparison with joint ultrasound

BackgroundOptical spectral transmission (OST) is a modern diagnostic modality, able to assess the blood-specific absorption of light transmitted through a tissue, promising quantification of inflammation in the finger and wrist joints of patients with arthritis. To date, there are no adequate data regarding the diagnostic value of OST in the evaluation of inflammatory activity changes, during arthritis follow-up.Objectives of this study were therefore to examine the performance of OST in assessing response to anti-inflammatory therapy in patients with active arthritis and to explore OST associations with clinical, laboratory, and ultrasonographic (US) activity markers.Methods1173 joints of 54 patients with arthritides of the wrist and finger joints were examined by OST before and after oral administration of glucocorticoids (GC), during a disease flare. For the same time-points patients underwent clinical, laboratory, and joint US [grayscale (GSUS), power-Doppler (PDUS)] examinations. The distribution of ΔOST-values between the two time-points was compared with the respective distributions of ΔPDUS and ΔGSUS by Bayesian statistical analyses. Moreover, the diagnostic performance of OST compared to a control group (2508 joints of 114 subjects) was examined by receiver operating characteristics and associations of OST values with clinical, laboratory, and arthrosonographic parameters were evaluated by correlation analyses.ResultsOST and US performed similarly in the assessment of inflammatory changes caused by GC (same value-change tendency in 83.2% of the cases). Bayesian statistics revealed no significant differences between ΔOST and ΔPDUS for all 3 examined joint categories (accuracy: metacarpophalangeal (MCP): 68.1%; proximal interphalangeal (PIP): 60.4%; wrists: 50.4%) and between ΔOST and ΔGSUS for MCP and PIP joints (accuracy: 51.1% and 78.7%, respectively). OST diagnostic performance (patients vs. controls) was excellent in both time-points [area under the curve (AUC) before GC=0.883(95%CI=0.83–0.94) and after GC=0.811(95%CI=0.74–0.881); p<0.001]. Furthermore, OST correlated significantly with all examined sonographic activity scores (all; p<0.001) and with swollen joint counts (p<0.01).ConclusionsOST was able to assess response to therapy in a similar way to joint US and correlated significantly with arthritis activity markers. Therefore, OST has proved to be a valuable tool to assist disease activity monitoring in the examined cohort.Trial registrationGerman Registry of Clinical Trials, DRKS00016752

Smartband for Heartbeat and Oxygen Saturation Monitoring with Critical Warning to Paramedic via IoT

There are vital signs in the human body that indicate important physiological values for the body. In the COVID-19 pandemic, some of the important vital signs that must be monitored are BPM (Beats Per Minute) and SpO2 (oxygen saturation) as indicators of whether a person is in good health or lacks oxygen to predict the early symptoms of COVID-19. The purpose of this study is to create a device on the patient's wrist that can monitor BPM and SpO2 in real-time, as well as provide notifications on smartphones and emails when the patient's condition is abnormal. The contribution of this study is to implement an IoT (Internet of Things) system using a Wi-Fi connection so that monitoring activities are not separated by distance and time. The MAX86141 sensor is used in the design of this tool to detect the BPM and SpO2 values, after which the data is processed and displayed on the ESP32 TTGO T-Display. Monitoring results are also sent to the Blynk, and if the patient's condition is abnormal, an email notification is sent. According to the tool testing results, BPM has the smallest error of 0.94 percent and the largest error of 6.48 percent, whereas SpO2 has the smallest error of 0.20 percent and the largest error of 3.23 percent. The findings of this study can be used to improve the ease and efficiency of body health monitoring activities. This has the potential to significantly improve public health service quality, particularly during the COVID-19 pandemic

Long-term results of trans-scaphoid perilunate fracture dislocations treated by open reduction and internal fixation

PurposeThe paper holds the research purpose of confirming the long-term results of trans-scaphoid perilunate fracture dislocations (TSPFD) under the treatment of open reduction and internal fixation.MethodsAnteroposterial-lateral radiographs of the patient's wrist were taken before and after surgery. We use a dorsal approach for all cases. Postoperative clinical and radiographic assessments were performed routinely. The scapholunate angle (SLA), estradiol angle (RLA), as well as lunotriquetral distance (LTD) assisted in the radiographic assessment. Clinical assessment was performed using the Krimmer score, modified Mayo wrist score (MWS), active flexion extension arc (FEA), radial deviation and ulnar deviation arc (RUDA) and grip strength. A visual analog scale (VAS) assisted in the pain evaluation, the VAS score ranges from 0 to 10.ResultsTwenty-two TSPFD patients due to the wrist trauma received operative treatment and we retrospectively analyzed the surgical results, together with evaluating their clinical and radiological follow-up. These patients held a mean age of 30 years old. Herzberg’s perilunate fracture-dislocation classification was taken into account to find that 19 males and 3 females suffered dorsal dislocation. The fellow-up time lasted 98.3 months on average. All cases obtained sufficient union after open reduction and internal fixation. The last follow-up found the median of grip strength was 20.00 (interquartile range, 20.00–21.25), which was 84.5% of the normal side. The modified Mayo wrist score evaluation scale considered 12 cases as excellent, and 10 good. The median of VAS and Krimmer scores at the final follow-up were 1.50 (interquartile range, 0.75–2.00) and 100.00 (interquartile range, 100.00–100.00), respectively, higher relative to the pre-operation (P < 0.001). No patients showed nerve damage preoperatively or postoperatively, or pin tract infection in any of the patient.ConclusionsIt is necessary to diagnose such complicated biomechanical damage in early stage and adopt the open reduction and stable fixation for treatment; appropriate treatment can contribute to a functionally adequate and anatomically integrated wrist.

Effect of virtual reality and conventional physiotherapy on rehabilitation of distal radius fracture

Rehabilitation sometimes may be an uncomfortable and tiring method that incorporates multiple activities and sets of exercises which patients require to perform to achieve good prognosis, for a significant period of time. Unfortunately, most of times the patients frequently become not willing, aggravated, and need inspiration and feel exhausted which makes recovery from the condition will less proficient. Use of the Virtual Reality have been broadly executing into rehabilitation program intends to make the process of recovery more energizing, invigorating and engaging for patients. Within this protocol, we propose to utilization of head wearing gadget name Oculus Quest for patient's wrist recovery after Colle’s fracture. After receiving Institutional Ethical committee approval, we will include 40 Colle’s fracture patients, and randomly divide them in two groups. Further group A will receive conventional physiotherapy treatment and group B will receive treatment from Virtual reality as well as conventional treatment for 4 weeks. Pre and post treatment assessment for Pain, Range of motion and functional parameters will be evaluated. The primary aim study is to check the impact of virtual reality and conventional physiotherapy after Colle’s Fracture. This exploration will help in distinguishing quick and longterm impacts of Virtual reality in DRF patients. The investigation results would assist in forming the newly planned strategies with better prognosis in rehabilitation of patients with Colle’s fracture.

Accuracy of the Apple Watch Oxygen Saturation Measurement in Adults and Children with Congenital Heart Disease.

As new customer health devices have been spread throughout the consumer market in recent years, it now needs to be evaluated if they also fulfill the requirements of clinical use. The Apple Watch Series 6 provides a new health feature with its oxygen saturation measurement. The aim of this prospective, investigator-initiated, single-arm study was to compare transcutaneous oxygen saturation measurements using the Apple Watch 6 with the conventional method of pulse oximetry in patients with congenital heart disease. Patients of any age presenting at the Leipzig Heart Center, Department for pediatric cardiology, were included. After obtaining informed consent, the routine oxygen saturation measurement with the pulse oximeter was taken and simultaneously three measurements with the Apple Watch. A total of 508 patients were enrolled. Comparing children and adults in terms of measurement success shows a statistically significant difference with a higher proportion of unsuccessful measurements in children, but no difference concerning correct versus incorrect Apple Watch measurements. Noticeable, strapping on the watch properly around the patient's wrists significantly improved the measurements compared to a watch only laid on. The study demonstrated that oxygen saturation measurement with the Apple Watch 6 is not yet up to the medical standard of pulse oximetry, too large a proportion of the measurements remain either unsuccessful or incorrect. While a high proportion of unsuccessful measurements in children can be attributed to movement, the cause in adults usually remains unclear. Further influencing factors on a correct, or successful measurement could not be found.

A comparison of agreement between actigraphy and polysomnography for assessing sleep during posttraumatic amnesia.

Sleep disturbance often emerges in the early recovery phase following a moderate to severe traumatic brain injury, known as posttraumatic amnesia. Actigraphy is commonly employed to assess sleep, as it is assumed that patients in posttraumatic amnesia (who display confusion, restlessness, and agitation) would better tolerate this measure over gold-standard polysomnography (PSG). This study evaluated the agreement between PSG and actigraphy for determining (sleep/wake time, sleep efficiency, sleep latency, and awakenings) in patients experiencing posttraumatic amnesia. It also compared the epoch-by-epoch sensitivity, specificity, and accuracy between the Actigraph device's 4 wake threshold settings (low, medium, high, and automatic) to PSG. The sample consisted of 24 inpatients recruited from a traumatic brain injury inpatient rehabilitation unit. Ambulatory PSG was recorded overnight at bedside and a Philips Actiwatch was secured to each patient's wrist for the same period. There were poor correlations between PSG and actigraphy for all parameters (Lin's concordance correlation coefficient = < 0.80). The low threshold displayed the highest correlation with PSG for wake and sleep time, albeit still low. Actigraphy displayed low specificity (ranging from 17.1% to 36.6%). There appears to be a greater disparity between actigraphy and PSG for patients with increased wake time. Actigraphy, while convenient, demonstrated poorer performance in determining sleep-wake parameters in patients with significantly disturbed sleep. Ambulatory PSG can provide a clearer understanding of the extent of sleep disturbances in these patients with reduced mobility during early rehabilitation. Study findings can help design future protocols of sleep assessment during posttraumatic amnesia and optimize treatment. Fedele B, McKenzie D, Williams G, Giles R, Olver J. A comparison of agreement between actigraphy and polysomnography for assessing sleep during posttraumatic amnesia. J Clin Sleep Med. 2022;18(11):2605-2616.

MORPHOMETRY OF DISTAL RADIUS – A RADIOGRAPHIC STUDY IN NEPALESE POPULATION

Background: Distal radius fractures are common injuries. The outcome of the fractures depends upon the post reduction morphometric parameters. This study was aimed to assess the normal morphometric parameters of distal radius in Nepalese population. Methods: This was a prospective cross-sectional study of morphometric measurements of 150 distal radius on x rays of wrist joints of patients presenting to department of orthopedics at CMCTH from October 2020 to September 2021. Radial height, Radial inclination, Palmer tilt, Ulnar variance and Radial width in posteroanterior (PA) and lateral views were measured. The data obtained was analyzed to see the difference according to age, sex, side, dominance and ethnicity. Results: The mean values of Radial height, Radial inclination, Palmer tilt, Ulnar variance and Radial width posteroanterior and lateral were 11.75+-0.94mm, 22.75+-1.50 degrees, 10.51+-1.04 degrees, -0.51 to+-1.15 mm, 27.05+-1.16 mm and 18.7+-1.12 mm respectively. Conclusions: The distal radius morphometry of Nepalese population is comparable to other national, regional and western similar studies. There were no any statistically significant differences of all the morphometric parameters of distal radius according to age, sex, side, dominance and ethnicity except Radial inclination, according to ethnicity; and Radial width, according to ethnicity and dominance.

Persistent Autonomic Engagement and Cardiac Control After Four or More Years of Autonomic Regulation Therapy Using Vagus Nerve Stimulation.

IntroductionAlthough heart failure (HF) outcomes have improved dramatically with the use of guideline directed medical therapy and implantable devices, the overall prognosis of patients with HF and reduced ejection fraction (HFrEF) remains poor. Autonomic Regulation Therapy (ART) using chronic vagus nerve stimulation (VNS) has been evaluated in the ANTHEM-HF study, using changes in heart rate (HR) dynamics as a biomarker of autonomic nervous system engagement and cardiac control to guide VNS titration. ART was associated with sustained improvement in cardiac function and HF symptoms in patients with HFrEF and persistent HF symptoms despite guideline-directed medical therapy (GDMT). We sought to determine whether the responsiveness of the autonomic nervous system to ART, as reflected in HR response to vagus stimulation during the VNS duty cycle, is maintained after long-term chronic VNS administration.MethodsFifteen patients with HFrEF and implanted with a VNS systems in the ANTHEM-HF study were evaluated after 4.7 ± 0.3 years (range: 4.0–5.0 years) of chronic ART. ECG electrodes were placed on each patient’s wrists, and ECG rhythm strips were recorded. Instantaneous HR time series was computed at each patient’s chronically programmed VNS intensity and during progressively increasing VNS intensity. HR during active stimulation (on-time) was compared to HR just prior to initiation of each stimulation cycle (off-time).ResultsPersistent autonomic engagement was observed in a majority of patients (11 of 15, 73%) after chronic ART for four or more years. The average magnitude of HR reduction during ART on-time in all patients was 2.4 ± 3.2 bpm at the chronically programmed VNS pulse parameter settings.ConclusionAutonomic responsiveness to VNS persists in patients with HFrEF who received chronic ART for up to 5 years as a supplement to GDMT. This suggests that the effects of ART on autonomic engagement and cardiac control remain durable over time.Clinical Trial Registration[ClinicalTrials.gov], identifier [#NCT01823887, CTRI registration #CTRI/2012/05/002681].

The ulnar artery: A site suitable for arterial cannulation in pediatric patients.

Historically, the ulnar artery has rarely been considered for arterial cannulation as it is less easily palpated than the radial artery. With the current routine use of ultrasound in pediatric patients, the ulnar is as accessible as the radial and could be viewed as an equivalent site for cannulation. The purpose of this study was to compare ulnar and radial artery suitability for arterial cannulation in pediatric patients using 2-dimensional ultrasound. We examined the ulnar and radial arteries of pediatric patients aged birth to 6years who were scheduled to undergo general anesthesia. Following anesthesia induction, the investigators positioned the patient's wrist to 30-45degrees of extension and obtained images of the ulnar and radial arteries in the transverse and longitudinal planes. Assessments of the arteries' anterior-posterior diameter, cross-sectional area and depth were made by visual inspection at the time of image acquisition and by electronic caliper measurement of recorded images. In 108 patients, mean anterior-posterior diameter of the ulnar artery was larger than the radial artery in the transverse view, longitudinal view, and cross-sectional area in 63.6%, 59.4%, and 60.4% of patients (p=.002, .004, and .006, respectively). Mean ulnar artery size was, on average, larger than the radial artery by 7.7%, 8.1%, and 12.9% in the transverse AP diameter, longitudinal AP diameter, and cross-sectional area (95% CI 3.1-12.4%; 3.2-13.0%; 4.4-21.5%). The investigator's visual evaluation of vessel size at the bedside showed substantial agreement with the measured cross-sectional area (linear-weighted kappa of 0.73). In a subset of 13 patients age <24months, the mean depth of the ulnar artery was 2.13mm compared to 1.65mm for the radial artery (difference -0.48mm 95% CI 1.08-0.12). The ulnar artery was larger than the radial artery in 60% of pediatric patients thus may offer an arterial cannulation site advantage due to its larger size. The use of 2-dimensional ultrasound examination allows accurate assessment of upper extremity distal arteries in order to optimize site selection for arterial cannulation in pediatric patients.

Analysis of Postoperative Complications and Related Factors Affecting Prognosis in 50 Patients with Distal Radius Fractures.

Objective To explore the postoperative complications of distal radius fractures and analyze the related factors that affect its prognosis. Methods The clinical data of 50 patients with distal radius fractures admitted to our hospital from October 2016 to September 2019 were retrospectively analyzed. All patients were followed up for 6–12 months, and their postoperative complications were recorded. Collect general patient information and related clinical data. During the follow-up process, Gartland and Werley wrist function scoring system was used to evaluate the prognosis of patients' joint function. Univariate analysis and multiple logistic regression models were used to analyze the related factors that affected the prognosis of patients. Results 15 patients with postoperative complications were found during the follow-up period, with an incidence rate of 30.00%. Univariate analysis showed that the patient's age, cause of injury, AO classification, shortened deformity, whether it was osteoporosis, surgical method, whether it was combined with other fractures on the same side, whether it was comminuted fracture, and the time to start postoperative exercise were all related to the distal radius. The prognosis of fractures is related (P < 0.05). Multivariate logistic analysis showed that age, AO classification, surgical method, whether it was combined with other fractures on the same side, whether it was comminuted fracture, and the time to start postoperative exercise were the independent factors affecting the prognosis of distal radius fractures (P < 0.05). Conclusion The postoperative complications of distal radius fractures are higher. The prognosis is related to the patient's age, AO classification, surgical method, whether it is combined with other fractures on the same side, whether it is comminuted fracture, and the time to start postoperative exercise. Therefore, choosing an appropriate surgical method and starting exercise in time can effectively improve the recovery of the patient's wrist function and reduce the occurrence of complications.

Smart-band BPM and Temperature Based on Android Using Wi-Fi Communication

Monitoring of patients is an integral part of health-care system, both in the hospital and at home. Monitoring devices are useful to monitor a person's health. Monitoring is necessary in case of symptoms of a disease that must be acted quickly to prevent the patient's condition from worsening. One way of monitoring patients' specifications is shown by their BPM value and temperature. The purpose of this study is the design of devices on a patient's wrist that can monitor BPM and his body temperature in real time and are not affected by distance. This research contribution is a system that can provide bradycardia indicators and tachycardia for BPM while hyperthermia and hypothermia for temperature. For a monitoring device to be more practical and efficient for use, it has a device with real time monitoring and a small frame of bracelets and alerts phones and emails during abnormal conditions. The design of the device uses the SEN0203 sensors as a BPM sensor that has analog and digital outputs, as well as MLX90614 sensors that have a digital output, and then data will be processed and shown live to oled ESP333TTGO and data sent to the blynk application on the phone aided by ESP32TTGO as a wifi module. The BPM has the smallest 0.1% error and the largest of 1.09% whereas the temperature has the smallest 0.19% and the largest of 1.63%. These results can be redeveloped on monitor patients to increase the efficiency of the remote monitoring system with alert conditions of patients at an abnormal time via mobile phones and emails.

POS1405 OPTICAL SPECTRAL TRANSMISSION (HANDSCAN) IN PATIENTS WITH PSORIATIC ARTHRITIS: FIRST DATA ON DIAGNOSTIC VALUE AND ASSOCIATIONS WITH CLINICAL AND ULTRASOUND DISEASE ACTIVITY MARKERS

Background:Valid assessment of disease activity leads to improvement of long-term outcomes in patients with inflammatory arthritis (1). Optical spectral transmission (OST) is a modern diagnostic tool able to assess the blood-specific absorption of light transmitted through a tissue, promising quantification of inflammation in the finger and wrist joints of patients with rheumatoid arthritis (RA) (commercial device: HandScan – Demcon/Hemics, The Netherlands) (2). Even though an increasing number of studies have evaluated diagnostic value of this new technology in RA patients (2,3), no data exist regarding psoriatic arthritis (PsA).Objectives:To examine for the first time the diagnostic value of OST in detecting inflammation in patients with PsA and to evaluate its relationship with disease activity markers and various epidemiological and anthropometric patient characteristics.Methods:OST-Measurements were performed in a group of PsA patients and a group of healthy controls. The difference between OST in the two groups was statistically examined and relationships of OST with clinical (tender / swollen joint counts, disease activity on a visual analogue scale) and serological disease activity markers were evaluated. Moreover, joint ultrasound (US) examinations were performed in a subgroup of PsA patients and OST associations with a Power Doppler- and a Grey Scale-US score were examined. Finally, relationships of OST with various anthropometric and epidemiologic parameters (BMI, hand-size, gender, age) were assessed.Results:We recruited 49 PsA patients [65.3% female; mean age 53.3 years (± 11.8 SD)] and 114 control subjects [77.2% female; mean age 46 years (± 12.8 SD)]. OST was statistically significantly higher in the patient group, compared to the control group [14.95 (12.04 - 17.18, IQR) vs. 10.31 (7.84 – 13.79, IQR); p&lt;0.001]. OST correlated moderately-strongly with both examined US scores (Power Doppler-score: r = 0.5; p = 0.026 and Grey Scale-score: r = 0.52; p = 0.028). Moreover, OST showed a moderate, statistically significant association with C-reactive protein (CRP) (r = 0,298; p = 0,037). Finally, males had significantly higher OST values than females and OST associated moderately-weakly with body mass index (BMI) in the control group (rho = 0.24; p&lt; 0.001).Conclusion:This is the first report of a possible diagnostic value of OST in patients with PsA. OST correlated with ultrasound and serological activity markers and may thus prove to be a useful tool of disease activity assessment, next to well established diagnostic modalities, such as the joint US. Correlations of OST with patient characteristics implicate the need to take also anthropometric and epidemiological patient characteristics into account when interprenting OST results in order to avoid confounding.