4,195 research outputs found
Assessing the Risk-Benefit Ratio of Scoliosis Surgery in Cerebral Palsy: Surgery Is Worth It
No full textBACKGROUND:
The true benefits of scoliosis surgery in cerebral palsy (CP) remain uncertain. Our aims were to determine the benefits of spinal fusion according to health-related quality of life (HRQoL) improvement at long-term follow-up and to explore the effect of surgery-related complications on clinical outcomes.
METHODS:
The cases of consecutive patients who had Gross Motor Function Classification System (GMFCS) level-IV or V cerebral palsy with 5-year follow-up from a prospective, longitudinal, multicenter database were analyzed. Caregivers completed the Caregiver Priorities and Child Health Index of Life with Disabilities (CPCHILD) questionnaire and 4 Likert-type anchor questions preoperatively and at 1, 2, and 5 years of follow-up. Data on complications were collected prospectively. Preoperative CPCHILD scores were compared with postoperative scores at the 1, 2, and 5-year follow-up evaluations. Preoperative CPCHILD scores were compared with postoperative scores at the 1, 2, and 5-year follow-up evaluations using repeated-measures analysis of variance (ANOVA). Spearman correlation coefficient was used to explore the association between changes in the CPCHILD at 1, 2, and 5-year follow-up and the reported complications within the follow-up period. Similarly, a comparative analysis between the percentage distribution of the answers to the 4 anchor questions and the reported complications was also performed.
RESULTS:
Sixty-nine patients with a mean age (and standard deviation) of 13.4 ± 2.6 years at enrollment were analyzed. The major Cobb angle was a mean of 81.9° ± 26.7° preoperatively and improved to a mean of 28.7° ± 14.4° at 2 years and 30.7° ± 15.3° at 5 years postoperatively. Significant improvements in CPCHILD personal care, positioning, and comfort domains were noted at all time points. The mean increase in the total score was 7.19 (p < 0.001) at 1 year, and the score gain was maintained at 2 and 5 years postoperatively. The overall complication rate was 46.4% at 1 year, 1.4% between 1 and 2 years, and 4.3% at 2 to 5 years postoperatively, with surgical intervention required in 6 patients within 1 year and in 2 additional patients within 5 years following scoliosis surgery. There was no correlation between complications and CPCHILD scores postoperatively at all time points, with the only exception of a weak correlation (ρ = -0.450, p = 0.002) with CPCHILD comfort score at 1 year after surgery.
CONCLUSIONS:
Scoliosis surgery in patients with CP leads to a significant improvement in HRQoL, which is maintained 5 years following surgery. The substantial complication rate does not correlate with HRQoL changes postoperatively, suggesting that the benefits of surgery outweigh the risks in this fragile population.
LEVEL OF EVIDENCE:
Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence
Isrogrogidda Falka Af-soomaaliga: Aragti ku aadan Midaynta Qoraalkiisa
No full textQoraagu wuxuu diraasad ku sameeyey sidii loo midayn lahaa af Soomaaliga qoraaal ahaan loo adeegsada. Gaar ahaan wuxuu diiradda saarayaa sidii loo midayn lahaa qaababka isrogrogga falalka oo haatan loo adeegsado siyaabo aan midaysanayn.In questo articolo, l'autore analizza e avanza una proposta relativamente alla standardizzazione del somalo scritto, in particolar modo delle forme di coniugazione dei verbi somali che attualmente non sono scritte in modo omogenea.In this article, the author analyzes and provides a proposal about the standardization of written Somali, in particular relating to verb conjugation forms whose orthography still differs today.Cabdirashid M. Ismaaciil, Cabdalla C. Mansuur, Saynab A. Sharci (eds.
Coastal Research and its Economic Justification
No full textProper and thorough planning of coastal engineering projects is discussed and the economie justification of research work indicated. Examples are given concerning navigational problems, coastal protection problems, and harbor sediment problems.KWP-collectio
A Detailed Comparative Analysis of Anterior Versus Posterior Approach to Lenke 5C Curves
No full textSTUDY DESIGN:
Prospective cohort study.
OBJECTIVE:
To prospectively compare radiographic, perioperative, and functional outcomes between anterior spinal instrumentation and fusion (ASIF) and posterior spinal instrumentation and fusion (PSIF) in Lenke 5C curves.
SUMMARY OF BACKGROUND DATA:
Historically, ASIF has been the treatment of choice for treatment of thoracolumbar adolescent idiopathic scoliosis. More recently, PSIF has gained popularity for its ease, versatility, and amount of correction achieved. Current literature lacks a prospective comparative analysis between these two approaches to better aid treating surgeons in decision making when treating Lenke 5C curves.
METHODS:
A prospective, longitudinal multicenter adolescent idiopathic scoliosis database was used to identify 161 consecutive patients with Lenke 5C curves treated by ASIF with a dual rod system, or PSIF with a pedicle screw-rod construct. Pre- and 2-year postoperative radiographic data, Scoliosis Research Society outcome scores, and perioperative comparisons were made between the two approaches.
RESULTS:
A total of 69 patients were treated with ASIF and 92 patients with PSIF. Curve extent, magnitude, stable, and end vertebrae distribution before surgery were similar between the two groups. At 2-year follow-up, there were no significant differences in percentage correction of the main curve (ASIF: 59.1%, PSIF: 59.6%), C7 decompensation (ASIF: -0.6 ± 1.2, PSIF: -0.3 ± 1.4 cm), length of hospital stay (ASIF: 5.6 days, PSIF: 5.7 days), postoperative day conversion to oral pain medication (ASIF: 3.2 days, PSIF: 3.2 days), and SRS outcome scores (P = 0.560) between the two groups. The number of levels fused was significantly lower in ASIF group (ASIF: 4.7, PSIF: 6.3; P < 0.001), but PSIF resulted in significantly less disc angulation below lowest instrumented vertebrae (ASIF: 3.4°, PSIF: 1.7°; P = 0.011), greater lumbar lordosis (P < 0.001), and greater % correction of lumbar prominence (P = 0.017).
CONCLUSION:
The amount of correction achieved was similar between ASIF and PSIF. ASIF resulted in shorter fusions (average 1.6 levels) compared with PSIF. This was at the expense of increased disc angulation below the lowest instrumented vertebrae, less lumbar lordosis, and a lower % correction of the lumbar prominence than PSIF
Midaynta iyo Horumarinta Af-soomaaliga
No full textQoraagu wuxuu maqaalkan ku falanqaynayaa arrimo ku saabsan midaynta af Soomaaliga qoran, oo dadka qaarkood ay ku doodaan in ay dhibaato ka taagantahay, iyagoo u aanaynaya kala duwanaanta lahjadaha Soomaaliyeed iyo farta af Soomaaliga oo aan xasillayn. Qoraha oo soo bandhigayaa in arrimahaasu aanu sax ahayn, wuxuuna muujinayaa caqabadaha dhabta ah ee hortaagan houmarinta af Soomaaliga: afku wuxuu la'yahay dawlad si rasmi ah u adeegsato, weerar ba'anna waxaa ku haya af Ingiriisiga, xagga ereyadana nabaadguur xooggan ayaa ku dhacaya, gaar ahaan ereyada la xiriira dhaqanka Soomaaliyeed.L'autore, in questo articolo, analizzando la questione della lingua somala scritta, cerca di illustrare che la situazione del somalo standard non è cosi problematica come a detta di alcuni somali, specialmente, nell'ortografia e nella differenza tra i dialetti, ma il problema somalo è bensì riscontrabile in altri fattori: la mancanza di un stato che continui ad adottare il somalo come lingua ufficiale, l'estinzione di tantissimi vocaboli in disuso, nonché la forte influenza dalla lingua inglese.The author in this article, in analysing the written somali language, wants to show the somali standard situation is not so bad, like some Somalis say, especially in orthography and in vernaculars difference. In spite of, the somali language problem is recognisable in some others factors: lack of state that usually chooses somali language as official language, extinction of many terms in disuse and also the strong influence of English.Cabdirashid M. Ismaaciil, Cabdalla C. Mansuur, Saynab A. Sharci (eds.
Om inloppet ifrån Östersjön : till SöderTelje eller Egelsta wiken
No full textAuthor: Nathanael Gerhard af Schultén.Dated: "Carlberg den 12 Januari 1806."Digital reproduction, The National Library of Finland, Centre for Preservation and Digitisation, MikkeliA description of the Baltic Sea.TravelEuropeanaSchultén, Nathanael Gerhard af (1750-1825
Dwing als gebiedsontwikkelaar een duidelijke opdracht af
No full textTerwijl de context waarin gebiedsontwikkelaars werken alleen maar complexer wordt, ziet Co Verdaas, hoogleraar gebiedsontwikkeling, een aanhoudende neiging om keuzes vooruit te schuiven of te verhullen. Hij geeft zes tips om gebiedsontwikkelaars in hun kracht te zetten. “Zonder escalatie geen resultaat zou het devies moeten zijn.”Practice Chair Urban Area Developmen
Simple risk model predicts incidence of atrial fibrillation in a racially and geographically diverse population: the CHARGE-AF consortium
No full textFull author list omitted for brevity. For the full list of authors, see article.BACKGROUND: Tools for the prediction of atrial fibrillation (AF) may identify high-risk individuals more likely to benefit from preventive interventions and serve as a benchmark to test novel putative risk factors. METHODS AND RESULTS: Individual-level data from 3 large cohorts in the United States (Atherosclerosis Risk in Communities [ARIC] study, the Cardiovascular Health Study [CHS], and the Framingham Heart Study [FHS]), including 18 556 men and women aged 46 to 94 years (19% African Americans, 81% whites) were pooled to derive predictive models for AF using clinical variables. Validation of the derived models was performed in 7672 participants from the Age, Gene and Environment-Reykjavik study (AGES) and the Rotterdam Study (RS). The analysis included 1186 incident AF cases in the derivation cohorts and 585 in the validation cohorts. A simple 5-year predictive model including the variables age, race, height, weight, systolic and diastolic blood pressure, current smoking, use of antihypertensive medication, diabetes, and history of myocardial infarction and heart failure had good discrimination (C-statistic, 0.765; 95% CI, 0.748 to 0.781). Addition of variables from the electrocardiogram did not improve the overall model discrimination (C-statistic, 0.767; 95% CI, 0.750 to 0.783; categorical net reclassification improvement, -0.0032; 95% CI, -0.0178 to 0.0113). In the validation cohorts, discrimination was acceptable (AGES C-statistic, 0.664; 95% CI, 0.632 to 0.697 and RS C-statistic, 0.705; 95% CI, 0.664 to 0.747) and calibration was adequate. CONCLUSION: A risk model including variables readily available in primary care settings adequately predicted AF in diverse populations from the United States and Europe
First Maltese record of Stephanopachys quadricollis (Marseul, 1879) (Coleoptera, Bostrichidae)
No full textThree specimens of Stephanopachys quadricollis (Marseul, 1878) were recently found in Malta in UV light
traps and represent the first record of this species for this country. Although S. quadricollis is native to
the Mediterranean basin, it is not yet clear if these Maltese records are due to a natural population or to
an interception. Distributional, nomenclatural and biological data on this species are summarized, and a
new synonymy is established: Stephanopachys quadricollis (Marseul, 1879) = Stephanopachys quadraticollis
Kocher, 1956, syn. n.peer-reviewe
Picture This: The Art and Business of Children's Books
No full textThe FIT Library presented "Love Your Library -- Picture This: The Art and Business of Children's Books" on Wednesday, Dec. 7th, 2016. William Low (FIT prof., painter, illustrator), Liz Starin (FIT alum and children's book illustrator) and Colleen AF Venable (author and Art Director for Workman Publishing) discussed their background, inspiration, technique, and tricks of the trade. Moderated by Leslie Preston
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