Treatment of chronic anterior shoulder dislocation by open reduction and simultaneous Bankart lesion repair

<p>Abstract</p> <p>Background</p> <p>Untreated chronic shoulder dislocation eventually leads to functional disability and pain. Open reduction with different fixation methods have been introduced for most chronic shoulder dislocation. We hypothesized that open reduction and simultaneous Bankart lesion repair in chronic anterior shoulder dislocation obviates the need for joint fixation and leads to better results than previously reported methods.</p> <p>Methods</p> <p>Eight patients with chronic anterior dislocation of shoulder underwent open reduction and capsulolabral complex repair after an average delay of 10 weeks from injury. Early motion was allowed the day after surgery in the safe position and the clinical and radiographic results were analyzed at an average follow-up of one year.</p> <p>Results</p> <p>The average Rowe and Zarin's score was 86 points. Four out of eight shoulders were graded as excellent, three as good and one as fair (Rowe and Zarins system). All patients were able to perform their daily activities and they had either mild or no pain. Anterior active forward flexion loss averaged 18 degrees, external active rotation loss averaged 17.5 degrees and internal active rotation loss averaged 3 vertebral body levels. Mild degenerative joint changes were noted in one patient.</p> <p>Conclusion</p> <p>The results show that the overall prognosis for this method of operation is more favorable than the previously reported methods and we recommend concomitant open reduction and capsulolabral complex repair for the treatment of old anterior shoulder dislocation.</p> <p>Level of Evidence</p> <p>Therapeutic study, Level IV (case series [no, or historical, control group])</p

Risk Factors for Anaplastic Thyroid Cancer

Background. Anaplastic thyroid cancer (ATC) is a form of thyroid cancer with very poor prognosis, but is fortunately quite rare. Its aetiology is unknown and not well researched. Aim. The aim of this study was to identify potential risk factors for ATC. Material and Method. Case-control study of 126 ATC patients (77 females and 49 males) and 252 controls individually matched by gender, age, and place of abode. In statistical analysis we used a Cox regression model. Results. Univariate logistic regression showed that the risk factors for ATC are low education level, type B blood group, goitre, other nonthyroid malignancies, diabetes, late menarche, and an early first pregnancy. Multivariate logistic regression analysis showed that independent risk factors for ATC are low education level (OR = 1.42, 95% CI = 1.09-1.86), type B blood group (OR = 2.41, 95% CI = 1.03-5.66), and goitre (OR = 25-33, 95% CI = 5.66-126.65). Conclusion. Independent risk factors for ATC are: low education level, type B blood group, and goitre

Establishing the European diagnostic reference levels for interventional cardiology.

Interventional cardiac procedures may be associated with high patient doses and therefore require special attention to protect the patients from radiation injuries such as skin erythema, cardiovascular tissue reactions or radiation-induced cancer. In this study, patient exposure data is collected from 13 countries (37 clinics and nearly 50 interventional rooms) and for 10 different procedures. Dose data was collected from a total of 14,922 interventional cardiology procedures. Based on these data European diagnostic reference levels (DRL) for air kerma-area product are suggested for coronary angiography (CA, DRL = 35 Gy cm &lt;sup&gt;2&lt;/sup&gt; ), percutaneous coronary intervention (PCI, 85 Gy cm &lt;sup&gt;2&lt;/sup&gt; ), transcatheter aortic valve implantation (TAVI, 130 Gy cm &lt;sup&gt;2&lt;/sup&gt; ), electrophysiological procedures (12 Gy cm &lt;sup&gt;2&lt;/sup&gt; ) and pacemaker implantations. Pacemaker implantations were further divided into single-chamber (2.5 Gy cm &lt;sup&gt;2&lt;/sup&gt; ) and dual chamber (3.5 Gy cm &lt;sup&gt;2&lt;/sup&gt; ) procedures and implantations of cardiac resynchronization therapy pacemaker (18 Gy cm &lt;sup&gt;2&lt;/sup&gt; ). Results show that relatively new techniques such as TAVI and treatment of chronic total occlusion (CTO) often produce relatively high doses, and thus emphasises the need for use of an optimization tool such as DRL to assist in reducing patient exposure. The generic DRL presented here facilitate comparison of patient exposure in interventional cardiology

Transfer reactions in Pb 206 + Sn 118: From quasielastic to deep-inelastic processes

We measured multinucleon transfer reactions for the Pb206+Sn118 system at Elab=1200 MeV by employing the large solid angle magnetic spectrometer PRISMA. Differential and total cross sections and Q-value distributions have been obtained for a variety of neutron and proton pick-up and stripping channels. The Q-value distributions show how the quasielastic and deep inelastic processes depend on the mass and charge of the transfer products. The corresponding cross sections have been compared with calculations performed with the grazing code. An overall good agreement is found for most of the few nucleon transfer channels. The underestimation of the data for channels involving a large number of transferred nucleons indicates that more complicated processes populate the given isotopes