85 research outputs found
Ganganalytische Studie zur Entlastungs-Coxa-valga (antetorta) orthetisch und prothetisch versorgter Kinder
No full textZiel: In der vorliegenden Arbeit sollte in einem ersten Schritt überprüft werden, wie sich bei Kindern, die aufgrund einer nicht behebbaren, einseitigen Beindeformität distal des Kniegelenkes dauerhaft orthetisch oder prothetisch versorgt werden müssen, die primär gesunde Hüfte des betroffenen Beines sekundär verformt. In einem zweiten Schritt sollte mittels Ganganalyse evaluiert werden, welcher Pathomechanismus der diagnostizierten Formstörung zu Grunde liegt.
Methodik: Das Patientengut bestand aus zwölf primär hüftgesunden, jedoch einseitig distal des Knies erkrankten, orthesenpflichtigen Kindern und Jugendlichen, deren klinische und radiologische Krankheitsverläufe retrospektiv ausgewertet wurden. Bei zehn der betroffenen Kinder konnte eine verwertbare instrumentelle kinetische und kinematische Ganganalyse mittels des Zebris-Systems durchgeführt werden.
Ergebnisse: 1. Grunderkrankungen: Crus varum congenitum oder Tibiapseudarthrosen 5, Fehlbildungsklumpfuß 1, kongenitaler tibialer Längsdefekt 2, kongenitaler fibulärer Längsdefekt 3, Unterschenkeldeformität nach Ewingsarkom 1.
2. Klinische Ergebnisse: Im intraindividuellen Seitvergleich ist die Seite des von der Deformität betroffenen Beines wie folgt verändert: Die Hüftinnenrotation ist durchschnittlich 12,5º signifikant vermehrt (p <0,05), die Hüftaußenrotation um 20-22,5º verkleinert.
3. Radiologische Ergebnisse: Koxales Femurende: Der projizierte CCD-Winkel ist altersabhängig und im Durchschnitt 14,71º signifikant steiler. Die Distanz zwischen Kopfkalotte und Trochanter minor (LTA) ist 1,58 cm signifikant vergrößert. Der Kopfepiphysen-Femurschaft-Winkel (KF) als Beweis der horizontalen Stellung der Kopfepiphysenfuge ist durchschnittlich um 13,52º vergrößert (p <0,05). Hüftpfanne: Der Sharp-Ullmann-Winkel ist 5,01º signifikant vergrößert und der Acetabulumwinkel (AC) ist 3,52º vergrößert (p <0,05).
3. Ganganalytische Ergebnisse: Kinetik: Die Schrittlänge ist um durchschnittlich 7 cm signifikant verlängert (p 0.05). Die Hüftabduktion der entlasteten Hüfte als Hinweis eines konstanten Duchenne-Hinkens ist durchschnittlich um 16,81º vermehrt.
Schlussfolgerung: Zusammenfassend kann gesagt werden, dass die einseitig orthetisch/prothetisch versorgten Kinder eine Formstörung der Hüfte aufwiesen, die in der älteren Literatur als Entlastungs-Coxa-valga bzw. Entlastungsdysplasie bezeichnet wird. Erstmals konnten die pathogenetischen Faktoren identifiziert werden, die diese Formstörung hervorrufen. Die Patienten weisen ein Duchenne-Hinken auf und belasten das betroffene Bein weniger stark und mit kürzerer Zeitspanne.
Die Untersuchung bestätigt in eindrucksvoller Weise die allgemeinen Wachstumsgesetze des muskulo-skelettalen Organs, die unter dem Merksatz „form follows function“ zusammengefasst werden können. Als praktische Konsequenz für den Klinikalltag ergibt sich die Forderung, die Hüfte orthesenpflichtiger Kinder in größeren Abständen klinisch und bildgebend zu screenen und die Orthesen- bzw. Prothesenaufbau so zu gestalten, dass ein Duchenne-Hinken vermieden wird.Title: Gait analysis study of Unloading-Coxa-Valga (antetorta) in orthoses/prostheses-dependent children
Background: During loading cycles, the joints’ geometry is continually modelled. Orthotics/prosthetics-dependent children develop ipsilateral in-toeing gait and Duchenne’s limping due to unilateral severe lower leg or foot deformities. These clinical phenomena are accompanied with an ipsilateral coxa-valga antetorta and hip dysplasia. A practical question is whether these hips are in danger to decompensate. An additional theoretical question is, how the external shape and internal architecture changes, if a primarily healthy hip is underused.
Methods: 10 children with healthy hips, who are unilaterally long-term orthotics/prosthetics-dependent, agreed to undergo an instrumental gait analysis. The results were analyzed and correlated with clinical findings, a common activity score and planimetric radiographic data.
Results: The intra-individual comparison revealed the following significant changes in the hip of the deformed leg (p <0.05). Clinically, the internal rotation was increased (12.5°), while the external rotation was diminished (20-22.5°). Radiologically, the projected CCD angle, the lesser trochanter to articular surface distance (LTA) and the head-shaft angle (CF) were increased by 14.71°, 1.58 cm and 13.52°, respectively. Both Sharp- and acetabular (AC) angles were increased by 5.01° and 3.52°, respectively. Kinetic gait analysis showed increased stride length (7 cm), shortened stance phase (6.35 %) and reduced forces transmitted to the ground (177.7 N). The kinematic analysis showed increased hip abduction (16.81°) while the pelvic obliquity was not significantly changed (0.08°).
Conclusions: Duchenne’s limping and lack of weight-bearing stress are the decisive pathogenic factors of the underuse-coxa-valga and acetabular dysplasia. These changes follow the mechanobiological concept “function modifies design”, that means function influences external shape and internal architecture of bones and joints. As a practical consequence we recommend to perform one pelvic radiograph as a precaution at the end of puberty of the diseased children.
Level of evidence: Level II retrospective stud
Al-Qaṣāʾid Fil-Madḥis Sayyidil-Maḥmoodi, Ṣallallāhu ʿalayhi wa Sallam (Panegyric poems for the Prophet)
No full textThe entire manuscript is available for download as a single PDF file. Higher-resolution images may
be available upon request. For technical assistance, please contact [email protected]. Fieldwork Team: Dr. Mustapha Hashim Kurfi (Principal Investigator), Malam
Umar Hajji Mustapha (Local Project Manager) and Abdullahi Mohammed (General Field Facilitator).
Technical Team: Prof. Fallou Ngom (Director African Studies Center), and Eleni Castro (Technical Lead, BU Libraries). This collection of Yoruba Anjemi materials are copied as part of the African Studies Center’s African Ajami Library. Access Condition and Copyright: These materials are subject to copyright. All rights reserved to the author. For use, distribution or reproduction contact Professor Fallou Ngom ([email protected]). Citation: Materials in this web edition should be cited as: Kurfi, Mustapha Hashim, Ngom, Fallou, and Castro, Eleni (2019). African Ajami Library: Digital Preservation of Yoruba Anjemi Materials of Southwestern Nigeria. Boston: Boston University Libraries: http://hdl.handle.net/2144/38122. For Inquiries: Please contact Professor Fallou Ngom ([email protected]).Provenance and Condition: This manuscript is owned by the Markaz Ihyahil Islam Abayawo, Ilorin – Nigeria, an institution, which propagates, teaches, and popularizes Yoruba Anjemi knowledge. This Al-Qaṣāʾid Yoruba Anjemi manuscript has 13 pages, which are all numbered using Roman numerals. This Yoruba Anjemi manuscript is in good condition and has the name of the translator/author As-Sheikh Al-Ḥājj Abubakar Yusuf As-Ṣūfī, with the date of publishing (1423 A.H.).This manuscript is a collection of panegyric poems in honor of Prophet Muḥammad. It is called "Al-Qaṣāʾid Fil-Madḥis Sayyidil-Maḥmoodi, Ṣallallāhu ʿalayhi wa Sallam," shortened as Al-Qaṣāʿid, which can be roughly translated as a set of Panegyric Poems for praising the leader of mankind, Peace and blessings of Allāh be upon him). Al-Qaṣāʾid, as the title suggests, hails and praises the unrivaled attributes of Prophet Muḥammad. The poems describe his virtuous characteristics, and what makes him unique, which include his being a chosen person, trustworthy, noble yet humble, generous, and compassionate. Like many prophetic poems – Waka, Al-Qaṣāʾid is a popular poem among the Yoruba Muslim communities. It is chanted in madrasas, as well as social gatherings, such as walimat (a banquet, dinner) during weddings, naming ceremonies, and so on. The author, Al-Ḥājj Abubakar Yusuf As-Ṣūfī uses the modern Mashriqi writing style, but with the special features of the Yoruba diacritics.The contents of this collection were developed with support of the Title VI National Resource Center grant # P015A180164 from the U.S. Department of Education. However, those contents do not necessarily represent the policy of the U.S. Department of Education, and you should not assume endorsement by the Federal Government
Nerve transfer versus nerve graft for reconstruction of high ulnar nerve injuries
No full textPurpose: To assess the efficacy of nerve transfer versus nerve grafting in restoring motor and sensory hand function in patients with complete, isolated high ulnar nerve injuries. Methods: A retrospective chart review was performed, at a minimum 2 years of follow-up, of 52 patients suffering complete, isolated high ulnar nerve injury between January 2006 and June 2013 in one specialized hand surgery unit. Twenty-four patients underwent motor and sensory nerve transfers (NT group). Twenty-eight patients underwent sural nerve grafting (NG group). Motor recovery, return of sensibility and complications were examined as outcome measures. The Medical Research Council scale was applied to evaluate sensory and motor recovery. Grip and pinch strengths of the hand were measured. Results: Twenty of 24 patients (83.33%) in the NT group regained M3 grade or greater for the adductor pollicis, the abductor digiti minimi, and the medial 2 lumbricals and interossei, compared with only 16 of 28 patients (57.14%) in the NG group. Means for percentage recovery of grip strengths compared with the other healthy hand were significantly higher for the NT group than the NG group. Sensory recovery of S3 or greater was achieved in more than half of each group with no significant difference between groups. Conclusions: Nerve transfer is favored over nerve grafting in managing high ulnar nerve injuries because of better improvement of motor power and better restoration of grip functions of the hand
Surgical treatment of medial patellofemoral ligament injuries achieves better outcomes than conservative management in patients with primary patellar dislocation: a meta-analysis
No full textImportance: Lateral patellar dislocation is a commonly encountered disorder that affects mainly young and active adults and is associated with potential long-term morbidity. Primary traumatic dislocations can result in injury to the medial patellofemoral ligament (MPFL). There is controversy in literature about the superiority of early surgical intervention over conservative treatment of MPFL injuries. Objective: The aim of this project was to undertake a meta-analysis to evaluate the clinical outcomes of the surgical management of MPFL injuries compared with conservative treatment in patients with primary patellar dislocation. Evidence review: A systematic review of the English literature combining electronic databases Allied and Complementary Medicine (AMED), Cumulative Index to Nursing and Allied Health Literature (CINAHL), Embase and MEDLINE ((Ovid) and PubMed) and the reference lists of the final studies was performed during the last week of June 2017 using Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Four eligible randomised controlled trials comparing MPFL repair/reconstruction to conservative management met our inclusion criteria. They were identified and critically appraised, and the results were quantitatively evaluated giving data of a total of 171 patients. They were divided into two groups: surgically treated group (92 patients) and conservatively treated group (79 patients). The performed surgical procedures included: reconstruction and repair of the MPFL. The conservative management group included mainly physiotherapy. The outcomes evaluated were the rate of recurrent dislocation of the patella and the Kujala score. Findings: Our analysis showed high statistical significance favouring the surgical management in reducing the redislocation rate (6.74%) in comparison with the conservative group (28.5%) (P<0.001). The surgical group also demonstrated significantly higher Kujala score (70.8) compared with the conservative group (59.8) (P<0.001). Conclusions and relevance: Contrary to the available current evidence in the literature, we report that the surgical management of MPFL injuries in patients with primary patellar dislocation results in a significantly reduced rate of redislocation when compared with non-operative management
Useful functional outcome can be achieved after motor nerve transfers in management of the paralytic hand. An observational study
No full textBackground: Nerve transfers have demonstrated encouraging outcomes in peripheral nerve reconstructions compared with the conventional direct repair or grafting. Questions/Purposes: We aimed to identify whether the patient’s demographics, delay to surgery, degree of loss of grip and pinch strengths, mechanism of injury, and compliance to hand therapy have an impact on the functional outcome of motor nerve transfers in patients with paralytic hand. Methods: Fifty-five patients with a mean age of 31.05 (18–48) years with complete isolated high injuries of radial, ulnar, and median nerves, who underwent motor nerve transfers, were reviewed. The outcome was assessed using the Medical Research Council (MRC) scale and measurement of grip and pinch strengths of the hand at minimum 1-year follow-up (mean of 14.4 (12–18) months). Patient’s age and gender, delay to surgery, body mass index (BMI), degree of loss of grip and pinch strengths, educational level, occupation, mechanism of injury, and compliance to hand therapy were analyzed to determine their impact on the extent of recovery of hand function. Results: Forty of fifty five (72.73%) patients regained useful functional recovery (M3–M4) with satisfactory grip hand functions. Worse motor recovery was observed in older ages, delayed surgical intervention, higher BMI, and greater postoperative loss of grip and pinch strengths in comparison to the healthy opposite hand. Better outcomes are significantly associated with higher educational level and postoperative compliance to hand therapy. Contrarily, there was no significant association between gender, occupation, mechanism of injury, and achievement of useful functional recovery
Applied Literature: Expanding Cultural Understanding For Language Learners
No full textThis study contributes to the empirical research on the use of literary texts in language learning. Specifically, it focuses on two groups of adult English language learners who are students at an American university as they read, write about, and discuss literature written by an author from the local area and which portrays the local culture in which the university is situated. This study seeks to examine how adopting an aesthetic stance can help foreign students, new to the university, evoke a wide range of responses and pay attention to language input and cultural context
Applied Literature: Expanding Cultural Understanding For Language Learners
No full textThis study contributes to the empirical research on the use of literary texts in language learning. Specifically, it focuses on two groups of adult English language learners who are students at an American university as they read, write about, and discuss literature written by an author from the local area and which portrays the local culture in which the university is situated. This study seeks to examine how adopting an aesthetic stance can help foreign students, new to the university, evoke a wide range of responses and pay attention to language input and cultural context.Language, Literacy and Socio-cultural StudiesMastersUniversity of New Mexico. Division of Language, Literacy and Sociocultural StudiesPence, LucretiaZancanell, DonaldBlum- Martinez, Rebecc
Inverted femoral head graft versus standard core decompression in nontraumatic hip osteonecrosis at minimum 3 years follow-up
No full textPurpose: Numerous salvage surgeries were popularised to halt the progression of hip osteonecrosis (ON). We aimed to compare the clinico-radiological outcomes of inverted femoral head graft (IFHG) versus standard core decompression (SCD) in treatment of nontraumatic hip ON at pre-arthritic stage. Methods: A case review was performed at a minimum 3 years follow-up of 61 patients (71 hips; mean age 32.96 (19-50) years; mean follow-up 7.86 (3-14) years; mean body mass index 28.58 (19-46); 32 males, 29 females) suffering nontraumatic hip ON at pre-arthritic stage. 38 hips underwent SCD and 33 IFHG. The outcome was assessed by changes in modified Harris Hip Score (MHHS), need for revision surgery and progression of modified Ficat-Arlet staging. Data were analysed including logistic regression and Kaplan-Meier survivorship analysis. Results: 13/34 (38.2%) hips in SCD group were revised at 4.61 ± 2.61 years, while 7/33 (21.2%) in IFHG group at 8.43 ± 4.32 years (p = 0.023). MHHS was significantly higher in IFHG group at 1 and 3 years as well as at last follow-up (p = 0.014, 0.001 and 0.023 respectively). Clinical and radiological significant differences were found in survivorship analysis between both groups, in favor of IFHG. A higher clinical failure was noted among obese patients. Conclusions: An IFHG technique offers a better alternative regarding postoperative clinico-radiological outcomes in nontraumatic hip ON at the pre-arthritic stage. A cautious prognosis is recommended in obese patients
Prevalence of, and risk factors for, trachoma and ocular Chlamydia trachomatis infection in The Gambia and Tanzania
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