Background: To compare the effect of different starting periods of rehabilitative exercise (early or delayed passive exercise) on the rate of retear and other clinical outcomes after the arthroscopic repair of the rotator cuff. Methods: In total, 103 patients who underwent arthroscopic repair of the rotator cuff were included in the study. Determined at 2 weeks post-operation, patients who were incapable of passive forward elevation greater than $90^{\circ}$ were allotted to the early exercise group (group I: 79 patients; 42 males, 37 females), whilst those capable were allotted to the delayed exercise group (group II: 24 patients; 14 males, 10 females). The group I started passive exercise, i.e. stretching, within 2 weeks of operation, whilst group II started within 6 weeks. The results were compared on average 15.8 months (11-49 months) post-operation using the passive range of motion, the Visual Analog Scale (VAS) pain score, and the University of California at Los Angeles (UCLA) and Constant scores. Stiffness was defined as passive forward elevation or external rotation of less than $30^{\circ}C$ compared to the contralateral side. Follow-up magnetic resonance imaging (MRI) was carried out on average 1 year post-operation and the rate of retear was compared with Sugaya's criteria. Results: There were no differences between the two groups in gender, age, smoking, presence of diabetes, arm dominance, period of tear unattended, pre-operative range of motion, shape and size of tear, degree of tendon retraction, and tendon quality. There were no significant differences in clinical outcomes. Whilst stiffness was more frequent in group II (p-value 0.03), retear was more frequent in group I (p-value 0.028) according to the MRI follow-up. Conclusions: During rehabilitation after the arthroscopic repair of the rotator cuff, the delay of passive exercise seems to decrease the rate of retear but increase the risk of stiffness.
Background: Traumatic spinal cord injury (SCI) is a tragic event that has a major impact on individuals and society as well as the healthcare system. The purpose of this study was to investigate the strength of association between surgical treatment timing and neurological improvement. Methods: Fifty-six patients with neurological impairment due to traumatic SCI were included in this study. From January 2013 to June 2017, all their medical records were reviewed. Initially, to identify the factors affecting the recovery of neurological deficit after an acute SCI, we performed univariate logistic regression analyses for various variables. Then, we performed a multivariate logistic regression analysis for variables that showed a p-value of < 0.2 in the univariate analyses. The Hosmer-Lemeshow test was used to determine the goodness of fit for the multivariate logistic regression model. Results: In the univariate analysis on the strength of associations between various factors and neurological improvement, the following factors had a p-value of < 0.2: surgical timing (early, < 8 hours; late, 8-24 hours; p = 0.033), completeness of SCI (complete/incomplete; p = 0.033), and smoking (p = 0.095). In the multivariate analysis, only two variables were significant: surgical timing (odds ratio [OR], 0.128; p = 0.004) and completeness of SCI (OR, 9.611; p = 0.009). Conclusions: Early surgical decompression within 8 hours after traumatic SCI appeared to improve neurological recovery. Furthermore, incomplete SCI was more closely related to favorable neurological improvement than complete SCI. Therefore, we recommend early decompression as an effective treatment for traumatic SCI.
Goedderz, Cody;Plantz, Mark A.;Gerlach, Erik B.;Arpey, Nicholas C.;Swiatek, Peter R.;Cantrell, Colin K.;Terry, Michael A.;Tjong, Vehniah K.
Clinics in Shoulder and Elbow
/
v.25
no.1
/
pp.36-41
/
2022
Background: Distal biceps rupture is a relatively uncommon injury that can significantly affect quality of life. Early complications following biceps tendon repair are not well described in the literature. This study utilizes a national surgical database to determine the incidence of and predictors for short-term complications following distal biceps tendon repair. Methods: The American College of Surgeons' National Surgical Quality Improvement Program database was used to identify patients undergoing distal biceps repair between January 1, 2011, and December 31, 2017. Patient demographic variables of sex, age, body mass index, American Society of Anesthesiologists class, functional status, and several comorbidities were collected for each patient, along with 30-day postoperative complications. Binary logistic regression was used to calculate risk ratios for these complications using patient predictor variables. Results: Early postoperative surgical complications (0.5%)-which were mostly infections (0.4%)-and medical complications (0.3%) were rare. A readmission risk factor was diabetes (risk ratio [RR], 4.238; 95% confidence interval [CI], 1.180-15.218). Non-home discharge risk factors were smoking (RR, 3.006; 95% CI, 1.123-8.044) and ≥60 years of age (RR, 4.150; 95% CI, 1.611-10.686). Maleness was protective for medical complications (RR, 0.024; 95% CI, 0.005-0.126). Surgical complication risk factors were obese class II (RR, 4.120; 95% CI, 1.123-15.120), chronic obstructive pulmonary disease (COPD; RR, 21.981; 95% CI, 3.719-129.924), and inpatient surgery (RR, 8.606; 95% CI, 2.266-32.689). Conclusions: Complication rates after distal biceps repair are low. Various patient demographics, medical comorbidities, and surgical factors were all predictive of short-term complications.
Daniel G. Meeker;Maria F. Bozoghlian;Taylor Den Hartog;Jill Corlette;James V. Nepola;Brendan M. Patterson
Clinics in Shoulder and Elbow
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v.27
no.2
/
pp.169-175
/
2024
Background: Incidental findings are commonly noted in advanced imaging studies. Few data exist regarding the rate of incidental findings on computed tomography (CT) for preoperative shoulder arthroplasty planning. This study aims to identify the incidence of these findings and the rate at which they warrant further work-up to help guide orthopedic surgeons in counseling patients. Methods: A retrospective review was performed to identify patients with available preoperative shoulder CT who subsequently underwent shoulder arthroplasty procedures at a single institution between 2015 and 2021. Data including age, sex, and smoking status were obtained. Radiology reports for CTs were reviewed for incidental findings and categorized based on location, tissue type, and/or body system. The rate of incidental findings and the rate at which further follow-up was recommended by the radiologist were determined. Results: A total of 617 patients was identified. There were 173 incidental findings noted in 146 of these patients (23.7%). Findings ranged from pulmonary (59%), skin/soft tissue (16%), thyroid (13%), vascular (9%), spinal (2%), and abdominal (1%) areas. Of the pulmonary findings, 50% were pulmonary nodules and 47% were granulomatous disease. Overall, the final radiology report recommended further follow-up for 50% of the patients with incidental findings. Conclusions: Incidental findings are relatively common in preoperative CTs obtained for shoulder arthroplasty, occurring in nearly one-quarter of patients. Most of these findings are pulmonary in nature. Overall, half of the patients with incidental findings were recommended for further follow-up. These results establish population data to guide orthopedic surgeons in patient counseling. Level of evidence: III.
Data on the association between dietary red meat intake and non-alcoholic fatty liver disease (NAFLD) are limited. We designed this case-control study to determine the association between red and processed meat consumption and risk of NAFLD in Iranian adults. A total of 999 eligible subjects, including 196 NAFLD patients and 803 non-NAFLD controls were recruited from hepatology clinics in Tehran, Iran. A reliable and validated food frequency questionnaire was used to evaluate the red and processed meat intakes. The analyzes performed showed that in an age- and gender-adjusted model, patients with the highest quartile of red meat intake had an approximately three-fold higher risk of NAFLD than those with the lowest quartile of intake (odds ratio [OR], 3.42; 95% confidence interval [CI], 2.16-5.43; p value < 0.001). Moreover, patients in the highest quartile of processed meat intake had a 3.28 times higher risk of NAFLD, compared to the lowest quartile(OR, 3.28; 95% CI, 1.97-5.46; p value < 0.001).Both these associations remained significant by implementing additional adjustments for body mass index, energy intake, dietary factors, diabetes, smoking, and physical activity (OR, 3.65; 95% CI, 1.85-7.18; p value < 0.001 and OR, 3.25; 95% CI, 1.57-6.73; p value = 0.002, respectively).Our findings indicate that both red and processed meat intakes are related to the increased odds of NAFLD; however, prospective studies are needed to confirm these results.
The purpose of this study was to serve as a basis for the planning of oral health education and the development of an oral health-promotion program for patients who visited dental clinics by examining how much dental hygienists offered oral health education to adult patients at dental clinics. A parent group was selected, being made up of 1,600 dental hygienists who registered with the Dental Hygienist Association and worked in Seoul. The questionnaire survey was carried out and an ${\chi}^2-test$ was made using the data collected from 218 subjects to determine how their practice of oral health education was different according to certain general characteristics(the sort of organization for which they worked, age, the term of their service, and the mean number of patients per day). As a result, the following findings were obtained: 1. Thees general characteristics made the following differences to the content of oral health, education: The sort of organization for which the subjects worked made a significant difference in the following tooth brushing instruction (p<0.05), the effect of oral prophylaxis or education about aftereffects (p<0.05), the regular examination of prosthesis (p<0.05), smoking-prohibition education (p<0.05), and the prevention poor-quality fillings (p<0.01). The mean number of patients per day made significant differences to the regular examination of prosthesis (p<0.05) and the prevention poor-quality fillings (p<0.01). But no significant disparity was generated by age or the term of service. 2. The general characteristics made the following differences to education about nutrition and diet counseling: The sort of organization for which the subjects worked had a significant effect just on the importance of a balanced menu (p<0.05). Age made significant differences in advice for vitamin, mineral, protein or other nutrients (p<0.01), and the importance of balanced menu (p<0.001). The term of service made significant differences in the importance of balanced menu (p<0.01), and advice for nutrients including vitamin, mineral or protein (p<0.01). 3. The general characteristics made the following differences to the recommendation and use of oral hygiene aids: The sort of oragnization for which they worked made significant differences only to a gingival massager and water pick (p<0.05). No significant difference was produced by age, the term of service or the mean number of patients per day. 4. The use of educational media for oral health was different according to the general characteristics: The use of pamphlets or booklets significantly varied depending on the organization for which they worked and with the mean number of patients per day (p<0.05). The use of slides or slide projectors was significantly affected by age (p<0.05). But no significant disparity was yielded by the term of service. 5. The general characteristics made the following difference as to whether a continued oral management system was carried out or not: The sort of organization for which they worked had very a significant effect on this result (p<0.001), and no significant disparity was made by age, the term of service or the mean number of patients per day. 6. The place where oral health education was giver differed according to the following general characteristics: The sort of organization for which they worked made very a significant difference as to the use of an examination room's dental unit chair or waiting room (p<0.01), and to the use of an oral health education room or reception counter (p<0.001). The term of service had a significant effect on the use of a counseling room (p<0.01). And the mean number of patients per day made significant differences in the use of a dental unit chair or reception counter (p<0.05), and to the use of an oral health education room or waiting room (p<0.01).
Purpose: The purpose of this study was to evaluate the survival and success rates of Korean Osstem implants US II Plus, GS II following loading period. Materials and Methods: Dental records were obtained in total 201 patients who were treated with Korean Osstem implants US II Plus, GS II on both maxillary and mandibular anterior and posterior areas in six different clinics for 2 years from January 2007 to December 2008. Total 430 implants were evaluated clinically and radiographically using predefined success criteria prospectively and following results were obtained. Result: US II Plus, GS II implants showed high survival rates of more than 99% and high success rates more than 90% independent of loading period. As a result of cross analysis to evaluate clinical significance between implant loading period and success rate, the P-value of US II Plus was 0.10 (P>0.05), and the P-value of GS II was 0.17 (P>0.05), which showed no statistical significance. Bone quality, smoking, and edentulous state are factors that can affect the survival and success rates following differently loaded implants, but did not significantly affect in this study. Conclusion: These results suggest that selection of loading period of Korean Osstem implants US II Plus, GS II would be done carefully considering implant install area, the quality alveolar bone, the state of edentulous ridge and experience of operator, though they showed clinically good results on both maxillary and mandibular anterior and posterior areas.
Hong, Yoonki;Lim, Myoung Nam;Kim, Woo Jin;Rhee, Chin Kook;Yoo, Kwang Ha;Lee, Ji-Hyun;Yoon, Ho Il;Kim, Tae-Hyung;Lee, Jin Hwa;Lim, Seong Yong;Lee, Sang Do;Oh, Yeon-Mok
Tuberculosis and Respiratory Diseases
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v.76
no.5
/
pp.226-232
/
2014
Background: Chronic obstructive pulmonary disease (COPD) is characterized by airflow limitation and results from environmental factors and genetic factors. Although cigarette smoking is a major risk factor, other environmental exposures can influence COPD. The purpose of this study is to investigate the clinical characteristics of COPD according to the history of environmental exposure. Methods: The study population comprised of 347 subjects with COPD who were recruited from the pulmonary clinics of 14 hospitals within the Korean Obstructive Lung Disease Study Group. We classified environmental exposures according to history of living near factory, and direct exposure history to firewood or briquette. According to living environmental exposures, we compared the frequency of respiratory symptoms, pulmonary function, quality of life, exercise capacity, and computed tomography phenotypes. Results: Thirty-one subjects (8.9%) had history of living near factory, 271 (78.3%) had exposure history to briquette, and 184 (53.3%) had exposure history to firewood. Patients with history of living near a factory had a significantly longer duration of sputum, while patients with exposure to firewood tended to have lower forced expiratory volume in one second, and patients with exposure to briquette tended to have lower six minute walk distance. Conclusion: COPD subjects with the history of living near factory had more frequent respiratory symptoms such as sputum. Our data suggest that environmental exposure may influence clinical phenotype of COPD.
This study was performed to investigate LBP(low-back pain) prevalence rate and its related factors inphysical therapists. A self-administered questionnaire survey was conducted to 522 physical therapists in Daegu and Gyeongsangbuk. The LBP prevalence rate for recent 6 months was $61.7\%$. According to age, the prevalence rate was highest in the group aged 24 or less for both male and female physical therapistis. For male physical therapists , it was higher in smokers and drivers, but for female ones, it was not in a significant relationship with smoking and driving. According to work experience, the prevalence rates of those who had been working for less than one year were the highest, and those who had been working at hospitals and clinics were $69.1\%$, significantly high. According to therapy techinque, the prevalence rate related ti PNF was $71.6\%$, the highest and to occupational therapy was $34.3\%$, the lowest. According to working environment for six months, in both male and female physical therapists. LBP prevalence rate was in a statistically significant relationship with work hours during the day, night and weekend duties, repetitive works, motions that bend or twist the waist, the number of patients per day, the number of time to help patients per day, the number of time to carry medical equipment per day and the length of time to work standing. The rate was also higher when physical therapists fekt nire stress from their work. According to the result of multiple logistic regression analysis, male was in a significant relationship with work experience and motions that bend or twist the waist and female was in a significant relationship with work hours during the night and weekend duties, the number of time to help patients per day, motions that bena or twist the waist, actions taken to protect the waist. As for the developmental pattem of LBP in the group of physical therapists with LBP for six moths, $15.7\%$ of them had LBP for first time, $42.3\%$ had recurred LBP, and $42.0\%$ had chronic LBP. As for the causes of LBP, $51.7\%$ said that it was because they worked in the same posture for a long time, and as for how to treat LBP, 48.8% said that they treated themselvs or got help from their co-wokers. The results presented above suggest that physical therapists are exposed to high risk of LBP caused form occupational activities. Therefire, it is necessary to improve working environment to reduce the occurrence of LBP and to develop education programs for preventing the occurrence and recurrence of LBP.
Journal of the Korea Academia-Industrial cooperation Society
/
v.12
no.6
/
pp.2598-2606
/
2011
This study investigated the relationship between job stress and psychosocial stress among clerical public officers in Daejeon City. The self-administered questionnaire survey was administered to 386, during the period between June 1, 2010 and July 31, 2010. As a results, In terms of various levels of psychosocial stresses, 8.8% of the subjects were healthy group, 64.5% were potential stress group, and 26.7% were high risk stress group. On job specifications, the high risk stress group were significantly higher those with higher level of job demand, lower job autonomy and lower colleagues support than their respective counterparts. The level of psychosocial stress was positively correlated with job demand and negatively correlated with job autonomy and social support. Multiple regression analysis revealed that the factors of influence on psychosocial stresses included subjective status of health, satisfaction in work, smoking, leisure activities, past history of visits to medical clinics, social support from colleagues.
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