14 research outputs found
Single Top Quark at Future Hadron Colliders. Complete Signal and Background Study
We perform a detail theoretical study including decays and jet fragmentation
of all the important modes of the single top quark production and all basic
background processes at the upgraded Tevatron and LHC colliders. Special
attention was paid to the complete tree level calculation of the QCD fake
background which was not considered in the previous studies. Analysis of the
various kinematical distributions for the signal and backgrounds allowed to
work out a set of cuts for an efficient background suppression and extraction
of the signal. It was shown that the signal to background ratio after optimized
cuts could reach about 0.4 at the Tevatron and 1 at the LHC. The remaining
after cuts rate of the signal at the LHC for the signature is
expected to be about 6.1 pb and will be enough to study the single top physics
even during the LHC operation at a low luminosity.Comment: 15 pages, LaTex, 7 figure
Current approach to diagnosis and treatment of children with osteogenesis imperfecta
Osteogenesis imperfecta (OI) is a heritable bone dysplasia characterized by bone fragility and long bone deformities. Approximately 85% of OI cases are caused by dominant autosomal mutations in the type I collagen coding genes (COL1A1 and COL1A2), which affect the quantity or structure of collagen. The remaining percentage of cases is caused by mutation in the proteins responsible for posttranslational modification, processing and crosslinking of collagen, bone mineralization, and osteoblast differentiation. In the past decade, new recessive, dominant, and X-linked inheritance. As a result, new types of OI were added to the Sillence classification, and a new genetic classification consisting of XVIII types is formed. Treatment of patients with OI is a complex task which requires a multidisciplinary care. Pharmacological treatment is based on bisphosphonate treatment, which increases the bone mineral density. In this article, we will describe other approaches in which the effectiveness is studied. Surgical treatment of the fractures and deformities of the extremities showed a positive effect on the patients’ quality of life, despite existing complications. There are a lot of debates about the choice between telescopic and non-telescopic fixators. Rehabilitation plays huge role in the recovery process after fracture and surgeries. © 2019, Eco-Vector LLC. All rights reserved
ОСЛОЖНЕНИЯ ХИРУРГИЧЕСКОГО ЛЕЧЕНИЯ ПЕРЕЛОМОВ И ДЕФОРМАЦИЙ КОНЕЧНОСТЕЙ У ДЕТЕЙ С НЕСОВЕРШЕННЫМ ОСТЕОГЕНЕЗОМ
Несовершенный остеогенез (НО) или болезнь Лобштейн Ворлика это гетерогенная наследственная дисплазия соединительной ткани, характеризующаяся частыми переломами и деформацией скелета, низкорослостью, изменением цвета склер, нарушением дентиногенеза, гиперэластичностью суставов и другими внескелетными проявлениями. Частые переломы костей, возникающие в результате низкоэнергетического воздействия,связаныснизкимкачествомкостнойтканиилисналичиемврожденнойилипосттравматическойдеформаций,чтоприводиткпереломам на их высоте. Консервативное лечение может приводить к развитию замкнутого круга: перелом - иммобилизация - постиммибилизационный остеопороз - перелом, что часто является причиной ограничения двигательной активности пациентов. Интрамедуллярный остеосинтез позволяет устранить смещение отломков, восстановить ось конечности, обеспечить интрамедуллярное шинирование и сократить сроки иммобилизации. Применение бисфосфонатов для повышения минеральной плотности кости значительно расширило хирургические возможности. Но несмотря на усовершенствование хирургической техники и внедрение комплексного мультидисциплинарного подхода частота осложнений остается чрезвычайно высокой. Тем не менее хирургическое лечение длинных трубчатых костей является методом выбора у данных пациентов и в большинстве случаев приводит к улучшению их качества жизни, позволяя им расширять свой двигательный режим
Complex approach to the conservative treatment of hallux rigidus [Комплексный подход к консервативному лечению пациентов с остеоартрозом первого плюснефалангового сустава]
Introduction. Hallux rigidus (HR) is a common source of forefoot pain, which leads to progressive loss of range of motion in the first metatarsophalangeal (MTP1) joint and pathologically affects biomechanics of the whole lower limb. HR is characterized by degeneration of the articular surfaces of MTP1 joint with the formation of bone growths, cysts and erosions, osteochondral defects and loose bodies. The frequency of occurrence of HR is 1 in 40 adults older than 50 years, and this localization of osteoarthritis is the most common among all joints of the foot. The aim of this article is to improve the results of conservative treatment of HR through the use of physical rehabilitation methods, such as manual therapy, therapeutic exercises and foot orthotics. Materials and methods. This study included retrospective cases of 24 patients (28 feet), who underwent a single course of conservative treatment of HR at the European Clinic for Sports Traumatology and Orthopedics (ECSTO) of the European Medical Center (EMC) since January 2014 to December 2018. The patients' mean age was 51 years (range, 41 to 69 years). Median time between the beginning of treatment and final examination was 26 months (interquartile range from 17 to 36 months). Patient satisfaction, VAS pain scale, AOFAS and FAAM questionnaires and MTP1 dorsiflexion were evaluated in this study. Results. According to AOFAS scale, we obtained 18% (5/28) of excellent, 78% (22/28) of good, 4% (1/28) of fair and no poor results. Median AOFAS score significantly increased from 58.5 points before treatment to 87.0 points on the final examination (p<0.05). Median FAAM daily activity subscale showed 98% of functional outcome with median subjective score of 95%, median FAAM sports score was 97% and median subjective sports score rate was 90%. Patient's satisfaction at the final examination was “excellent” in 57% (16/28), “good” in 39% (11/28), “fair” in 4% (1/28) of cases and no poor results were obtained. Median VAS pain scale decreased from 5 points before treatment to 1 point at the final examination (p<0.05). Median angle of the MTP1 dorsiflexion significantly increased from 23° before treatment to 30° on the final examination (p<0.05). Conclusion. Described approach of the conservative treatment of HR is an effective method of treatment of early stages of the disease with high patient satisfaction rate and functional outcome. © 2021 Ima-Press Publishing House. All rights reserved
Surgical treatment of comminuted intraarticular distal femur fracture in patient with osteogenesis imperfecta type I
Aim. Osteogenesis imperfecta (OI) is characterized by bone fragility and long bones deformities. Most studies are dedicated to surgical treatment of diaphyseal fractures. To our knowledge, there are no reports giving recommendations about surgical treatment of distal femur intraarticular fractures. Clinical case. We describe the surgical treatment of a 14-year-old girl with OI who had intraarticular fracture of the left distal femur and fracture of a right femur diaphysis. Surgical treatment was complicated by migration of a titanium elastic nail and impaired consolidation, which had to be fixed with a plate and led to peri-implant fracture. Results were assessed before trauma and at 1 and 2 years after trauma with Gillette Functional Assessment Questionnaire (GFAQ) and Bleck score. Discussion. During surgical treatment of comminuted intraarticular distal femur fractures in patients with OI, we had to use big cancellous screw that made implantation in an intramedullary fixator more difficult. Internal fixation with a plate in patients with OI is associated with high risks of peri-implant fracture. Conclusion. For treatment of comminuted intraarticular fracture of the distal femur, it is necessary to have large variety of internal fixators, follow the principles of absolute and relative stability, and be familiar with minimally-invasive techniques. © 2019, Eco-Vector LLC. All rights reserved
LONG-TERM OUTCOMES OF ALL-INSIDE MENISCAL REPAIR DURING ANTERIOR CRUCIATE LIGAMENT RECONSTRUCTION
Purpose: to evaluate long-term results of meniscal repair during arthroscopic ACL reconstruction. Materials and methods: 45 patients who underwent meniscal repair during arthroscopic ACL reconstruction between 2007 and 2013 by the same surgeon were included in the study. In total, fifty meniscus were repaired (26 medial and 24 lateral). Procedures included use of one up to four Fast-Fix implants (Smith & Nephew). In five cases both medial and lateral meniscus were repaired. Cincinnati, IKDC and Lysholm scales were used for long-term outcome analysis. Results: 19 male and 26 female patients were included in the study aging from 15 to 59 years (mean age 33,2+/-1,5). Median time from injury to surgical procedure was zero months (ranging zero to one). Mean time from surgery to scale analysis was 55,9+/-3 months (ranged 20-102). Median Cincinnati score was 97 (ranged 90-100), with excellent results in 93% of cases (43 patients) and good results in 7% (3 patients). Median IKDC score was 90,8 (ranged 86,2-95,4), with excellent outcomes in 51% of cases (23 patients), good - in 33% (15 patients) and satisfactory -in 16% (7 patients). Median Lysholm score was 95 (ranged 90-100), with excellent outcomes in 76% of cases (34 patients) and good in 24% (11 patients). Authors identified no statistical differences when comparing survey results in age, sex and time from trauma to surgery. Conclusions: Results of the present study match the data from orthopedic literature that prove meniscal repair as a safe and efficient procedure with good and excellent outcomes. All-inside meniscal repair can be used irrespectively of patients' age and is efficient even in case of delayed procedures
LONG-TERM OUTCOMES OF ALL-INSIDE MENISCAL REPAIR DURING ANTERIOR CRUCIATE LIGAMENT RECONSTRUCTION
Purpose: to evaluate long-term results of meniscal repair during arthroscopic ACL reconstruction. Materials and methods: 45 patients who underwent meniscal repair during arthroscopic ACL reconstruction between 2007 and 2013 by the same surgeon were included in the study. In total, fifty meniscus were repaired (26 medial and 24 lateral). Procedures included use of one up to four Fast-Fix implants (Smith & Nephew). In five cases both medial and lateral meniscus were repaired. Cincinnati, IKDC and Lysholm scales were used for long-term outcome analysis. Results: 19 male and 26 female patients were included in the study aging from 15 to 59 years (mean age 33,2+/-1,5). Median time from injury to surgical procedure was zero months (ranging zero to one). Mean time from surgery to scale analysis was 55,9+/-3 months (ranged 20-102). Median Cincinnati score was 97 (ranged 90-100), with excellent results in 93% of cases (43 patients) and good results in 7% (3 patients). Median IKDC score was 90,8 (ranged 86,2-95,4), with excellent outcomes in 51% of cases (23 patients), good - in 33% (15 patients) and satisfactory -in 16% (7 patients). Median Lysholm score was 95 (ranged 90-100), with excellent outcomes in 76% of cases (34 patients) and good in 24% (11 patients). Authors identified no statistical differences when comparing survey results in age, sex and time from trauma to surgery. Conclusions: Results of the present study match the data from orthopedic literature that prove meniscal repair as a safe and efficient procedure with good and excellent outcomes. All-inside meniscal repair can be used irrespectively of patients' age and is efficient even in case of delayed procedures
Shoulder instability: review of current concepts of diagnosis and treatment [Nestabil'nost' plechevogo sustava: obzor sovremennykh podkhodov k diagnostike i lecheniyu]
OBJECTIVE: To conduct a systematic review of modern literature data on the modern approaches in diagnosis and treatment of shoulder instability. MATERIAL AND METHODS: Searching for literature data was performed using the Pubmed and Google Scholar databases. RESULTS: The authors analyzed the results of conservative treatment of patients with shoulder instability and emphasized higher risk of instability recurrence, degeneration of anatomical structures and functional impairment in these patients. Surgery is advisable to restore shoulder stability and normalize its function. Several methods for stabilizing the shoulder have been proposed. The approaches to diagnosis and treatment of shoulder instability have been updated. CONCLUSION: Successful treatment of shoulder instability is based on qualitative and complete assessment of soft tissues and bone structures. An individual approach considering bone tissue deficiency and individual needs of the patient is required.Оптимальное лечение пациентов с нестабильностью плечевого сустава остается сложной и актуальной темой. В современной научной литературе нет единого мнения относительно тактики лечения пациентов, в том числе выбора типа трансплантата и вида хирургического вмешательства для пациентов с дефицитом костной массы гленоида и головки плечевой кости. ЦЕЛЬ ИССЛЕДОВАНИЯ: Провести систематический обзор современных данных литературы для определения новых подходов в диагностике и лечении нестабильности плечевого сустава. МАТЕРИАЛ И МЕТОДЫ: Проведен анализ публикаций по базам PubMed, Google Schoolar. РЕЗУЛЬТАТЫ: Рассмотрены результаты консервативного лечения пациентов с нестабильностью плечевого сустава, выявлено, что такой подход увеличивает риск рецидива нестабильности, дегенерации анатомических структур и функциональных нарушений сустава. Показана целесообразность своевременного выполнения хирургического лечения для восстановления стабильности плечевого сустава и нормализации его функции. К настоящему времени предложен ряд методов стабилизации плечевого сустава, актуализированы подходы к диагностике и лечению нестабильности плечевого сустава. ЗАКЛЮЧЕНИЕ: Успешность лечения нестабильности плечевого сустава базируется на качественной, полной оценке изменений мягких тканей и костных структур. Необходим индивидуальный подход к каждому пациенту, учитывающий дефицит костной ткани и индивидуальные потребности пациента
Особенности диагностики частичных разрывов вращательной манжеты плечевого сустава
Partial rotator cuff tears are the most common pathology of the shoulder joint. Diagnostic of such conditions is a challenging problem for trauma surgeon.Purpose of the study is to analyze the diagnostic significance of manual tests and the standard MRI of the shoulder joint.Materials and Methods. The study is a retrospective analysis of disease history data of 25 patients (15 males, 10 females) treated at the authors’ hospital during the period from 2014 to 2017. Examination was performed according to a standard protocol: assessment of shoulder range of motion, palpation, manual examination, including “full/empty can” test, a painful arc symptom and the Hawkins – Kennedy test. All patients underwent MRI of the shoulder joint. The mean age of patients was 50.8 years. Shoulder joint arthroscopic inspection was considered the gold standard for diagnostics.Results. After data analysis, the following results were obtained: sensitivity of the “full can” test was 68%, the accuracy was 68%; “empty can” test sensitivity and accuracy were 76%, respectively. MRI sensitivity for diagnostics of supraspinatus tendon ruptures was 84% with the accuracy of 84%. The combination of the Hawkins – Kennedy test with the symptom of painful arch demonstrated accuracy and sensitivity of 64%. The study evaluated the effectiveness of MRI for diagnostic of the rupture type: sensitivity for injury from the joint surface — 80%, from the subacromial space — 70%; specificity for ruptures from the articular surface — 90% and from the subacromial space — 93%. The accuracy was 84% for both types of ruptures.Conclusions. Combined application of manual tests and MRI of the shoulder joint allows to diagnose partial rotator cuff tears in the majority of cases.Частичные разрывы вращательной манжеты являются наиболее часто встречаемой патологией плечевого сустава. Диагностика таких состояний является сложной задачей для травматолога.Цель исследования — оценить значимость клинических тестов и стандартной МРТ плечевого сустава при диагностике частичных разрывов сухожилия надостной мышцы плечевого сустава.Материал и методы. Исследование представляет ретроспективный анализ историй болезней 25 пациентов (15 мужчин и 10 женщин), проходивших лечение в период с 2014 по 2017 г. Осмотр выполнялся по стандартизированному протоколу: оценка объема движений в плечевых суставах, пальпация, мануальное тестирование, в том числе тесты «full/empty can», симптом болезненной дуги и тест Hawkins – Kennedy. В рамках обследования всем пациентам выполняли МРТ плечевого сустава. Средний возраст пациентов на момент лечения 50,8 лет. «Золотым стандартом» диагностики считалась артроскопическая ревизия плечевого сустава.Результаты. В результате анализа данных были получены следующие значения: чувствительность теста «full can» — 68%, точность 68%; чувствительность и точность теста «empty can» составляют по 76% соответственно. Чувствительность МРТ в диагностике повреждения сухожилия надостной мышцы составила 84%, точность 84%. Комбинация теста Hawkins – Kennedy с симптомом болезненной дуги показала следующие результаты: точность и чувствительность — 64%. В рамках исследования проведена оценка эффективности МРТ в диагностике типа разрыва: чувствительность для повреждения со стороны суставной поверхности — 80%, со стороны субакромиального пространства — 70%; специфичность для разрывов со стороны суставной поверхности — 90%, для разрывов со стороны субакромиального пространства — 93%. Точность составила 84% для обоих типов разрывов.Заключение. Совместное применение мануальных тестов и МРТ плечевого сустава позволяет диагностировать частичный разрыв вращательной манжеты в большинстве случаев