123 research outputs found
Assessment of rotatory laxity in anterior cruciate ligament-deficient knees using magnetic resonance imaging with Porto-knee testing device
Purpose Objective evaluation of both antero-posterior
translation and rotatory laxity of the knee remains a target
to be accomplished. This is true for both preoperative
planning and postoperative assessment of different ACL
reconstruction emerging techniques. The ideal measurement tool should be simple, accurate and reproducible,
while enabling to assess both ‘‘anatomy’’ and ‘‘function’’
during the same examination. The purpose of this study is
to evaluate the clinical effectiveness of a new in-housedeveloped testing device, the so-called Porto-knee testing
device (PKTD). The PKTD is aimed to be used on the
evaluation of both antero-posterior and rotatory laxity of
the knee during MRI exams.
Methods Between 2008 and 2010, 33 patients with ACLdeficient knees were enrolled for the purpose of this study.
All patients were evaluated in the office and under
anesthesia with Lachman test, lateral pivot-shift test and
anterior drawer test. All cases were studied preoperatively
with KT-1000 and MRI with PKTD, and examinations
performed by independent observers blinded for clinical
evaluation. During MRI, we have used a PKTD that applies
antero-posterior translation and permits free tibial rotation
through a standardized pressure (46.7 kPa) in the proximal
posterior region of the leg. Measurements were taken for
both knees and comparing side-to-side. Five patients with
partial ruptures were excluded from the group of 33.
Results For the 28 remaining patients, 3 women and 25
men, with mean age of 33.4 ± 9.4 years, 13 left and 15 right
knees were tested. No significant correlation was noticed for
Lachman test and PKTD results (n.s.). Pivot-shift had a
strong positive correlation with the difference in anterior
translation registered in lateral and medial tibia plateaus of
injured knees (cor. coefficient = 0.80; p\0.05), and with
the difference in this parameter as compared to side-to-side
(cor. coefficient = 0.83; p\0.05).
Considering the KT-1000 difference between injured and
healthy knees, a very strong positive correlation was found
for side-to-side difference in medial (cor. coeffi-
cient = 0.73; p\0.05) and lateral (cor. coefficient = 0.5;
p\0.05) tibial plateau displacement using PKTD.
Conclusion The PKTD proved to be a reliable tool in
assessment of antero-posterior translation (comparing with
KT-1000) and rotatory laxity (compared with lateral pivotshift under anesthesia) of the ACL-deficient knee during
MRI examinatio
Validation of the western ontario rotator cuff index in patients with arthroscopic rotator cuff repair: A study protocol
<p>Abstract</p> <p>Background</p> <p>Arthroscopic rotator cuff repair is described as being a successful procedure. These results are often derived from clinical general shoulder examinations, which are then classified as 'excellent', 'good', 'fair' or 'poor'. However, the cut-off points for these classifications vary and sometimes modified scores are used.</p> <p>Arthroscopic rotator cuff repair is performed to improve quality of life. Therefore, disease specific health-related quality of life patient-administered questionnaires are needed. The WORC is a quality of life questionnaire designed for patients with disorders of the rotator cuff. The score is validated for rotator cuff disease, but not for rotator cuff repair specifically.</p> <p>The aim of this study is to investigate reliability, validity and responsiveness of WORC in patients undergoing arthroscopic rotator cuff repair.</p> <p>Methods/Design</p> <p>An approved translation of the WORC into Dutch is used. In this prospective study three groups of patients are used: 1. Arthroscopic rotator cuff repair; 2. Disorders of the rotator cuff without rupture; 3. Shoulder instability.</p> <p>The WORC, SF-36 and the Constant Score are obtained twice before therapy is started to measure reliability and validity. Responsiveness is tested by obtaining the same tests after therapy.</p
The neurology of COVID-19 revisited: A proposal from the environmental neurology specialty group of the world federation of neurology to implement international neurological registries
A comprehensive review of the neurological disorders reported during the current COVID-19 pandemic demonstrates that infection with SARS-CoV-2 affects the central nervous system (CNS), the peripheral nervous system (PNS) and the muscle. CNS manifestations include: headache and decreased responsiveness considered initial indicators of potential neurological involvement; anosmia, hyposmia, hypogeusia, and dysgeusia are frequent early symptoms of coronavirus infection. Respiratory failure, the lethal manifestation of COVID-19, responsible for 264,679 deaths worldwide, is probably neurogenic in origin and may result from the viral invasion of cranial nerve I, progressing into rhinencephalon and brainstem respiratory centers. Cerebrovascular disease, in particular large-vessel ischemic strokes, and less frequently cerebral venous thrombosis, intracerebral hemorrhage and subarachnoid hemorrhage, usually occur as part of a thrombotic state induced by viral attachment to ACE2 receptors in endothelium causing widespread endotheliitis, coagulopathy, arterial and venous thromboses. Acute hemorrhagic necrotizing encephalopathy is associated to the cytokine storm. A frontal hypoperfusion syndrome has been identified. There are isolated reports of seizures, encephalopathy, meningitis, encephalitis, and myelitis. The neurological diseases affecting the PNS and muscle in COVID-19 are less frequent and include Guillain-Barré syndrome; Miller Fisher syndrome; polyneuritis cranialis; and rare instances of viral myopathy with rhabdomyolysis. The main conclusion of this review is the pressing need to define the neurology of COVID-19, its frequency, manifestations, neuropathology and pathogenesis. On behalf of the World Federation of Neurology we invite national and regional neurological associations to create local databases to report cases with neurological manifestations observed during the on-going pandemic. International neuroepidemiological collaboration may help define the natural history of this worldwide problem
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