Pain, Functional Disability, Psychological Status, and Health-Related Quality of Life in Patients with Subacromial Impingement Syndrome

Background Subacromial impingement syndrome (SAIS) is the comments painful shoulder condition leading to considerable functional loss. Considering numerous existing conservative and surgical interventions for SAIS, the use of optimal patient-centred outcome measures is essential. Study assessed various generic and shoulder-specific outcome measures in patients and healthy controls to provide baseline data and facilitate the development of evidence-based interventions. Methods A total of 75 participants including 39 patients and 36 healthy controls were evaluated and compared by a battery of validated outcome tools: McGill Pain Questionnaire, Oxford Shoulder Score, Constant Murley Score, The Disability of the Arm, Shoulder and Hand, Upper Limb Function Index, Functional Impairment Test–Hand and Neck/Shoulder/Arm, Hospital Anxiety and Depression Scale, Short-Form Health Survey, and shoulder muscle strength. Results All selected measures showed significant differences in the pain experience, upper limb functional capacity, psychological status (anxiety and depression), and health-related quality of life between SAIS patients and healthy controls in both female and male participant groups (p<0.05 - p<0.001). Conclusion The use of an array of patient-centred upper limb regional/joint-specific pain and functional measures combined with psychological status and quality of life tools is recommended for the evidence-based assessment of intervention outcome in patients with SAIS

POSTURAL ALTERATIONS IN PATIENTS WITH SUBACROMIAL IMPINGEMENT SYNDROME.

BackgroundAn aberrant upper body posture has been proposed as one of the etiological factors contributing to the development of subacromial impingement syndrome (SAIS). Clinicians have translated this supposition into assessment and rehabilitation programs despite insufficient and conflicting evidence to support this approach.PurposeThe purpose of this study was to compare several postural variables between the SAIS patients and asymptomatic healthy controls.Study designCase-Control Study.MethodsA total of 75 participants including 39 patients (20 females; 19 males) and 36 healthy controls (15 females; 21 males) participated in the study. Study evaluated several postural variables including forward head posture (FHP), forward shoulder posture (FSP), thoracic kyphosis index (TKI), scapular index (SI), normalized scapular protraction (NSP), and the lateral scapular slide test (LSST). The variables were compared between patient and control groups according to sex.ResultsSignificant differences were observed in the female patients compared to asymptomatic controls for the FHP (49.38 + 9.6o vs 55.5o+8.38, p=0.03), FSP (45.58 + 10.1o vs 53.68 + 7.08, p=0.02), and LSST in third position (10.2 + 2.1cm vs 11.5 + 0.7cm, p=0.01). Male patients showed a significant difference only in the FSP compared to controls (61.9o+9.4o vs 49.78 + 9.28, pConclusionsWhile inadequate data on the relationship between dysfunctional posture and SAIS has led to broad variations in current rehabilitation strategies, the results of the present study revealed different patterns of postural aberrations in female and male patients with SAIS. This clarifies the need to develop individualized or sex-specific approaches for assessing posture in men and women with SAIS and rehabilitation programs based on the assessment results.Level of evidence3b

Subacromial Impingement Syndrome: An Electromyographic Study of Shoulder Girdle Muscle Fatigue

Muscle fatigue affecting glenohumeral and/or scapular muscles is suggested as one of the 25 contributing factors to the development of subacromial impingement syndrome (SAIS). 26 Nonetheless, the fatigability of shoulder girdle muscles in association with the pathomechanics 27 of SAIS has not been reported. This study aimed to measure and compare fatigue progression 28 within the shoulder girdle musculature of patients and healthy controls. 75 participants 29 including 39 patients (20 females; 19 males) and 36 healthy controls (15 females; 21 males) 30 participated in the study. Study evaluated the progression of muscle fatigue in 15 shoulder 31 girdle muscles by means of surface and fine-wire EMG during submaximal contraction of four 32 distinct movements (abduction, flexion, internal and external rotation). Shoulder strength, 33 subjective pain experience (McGill Pain Questionnaire), and psychological status (Hospital 34 Anxiety and Depression Scale) were also assessed. The results were compared between patient 35 and control groups according to the gender. Despite marked fatigue observed in the majority 36 of muscles particularly during flexion and abduction at 90°, overall results indicated a lower 37 tendency of fatigue progression in the impingement group across the tests (0.05< p <0.05). 38 Shoulder Strength, pain experience, and psychological status were significantly different 39 between the two groups (P<0.05). Lower tendency to fatigue progression in the impingement 40 group can be attributed to the presence of fear avoidance and pain-related muscle inhibition, 41 which in turn lead to adaptations in motor programme to reduce muscle recruitment and 42 activation. The significantly higher levels of pain experience and anxiety/depression in the 43 impingement group further support this proposition

DebriSat - A Planned Laboratory-Based Satellite Impact Experiment for Breakup Fragment Characterizations

The goal of the DebriSat project is to characterize fragments generated by a hypervelocity collision involving a modern satellite in low Earth orbit (LEO). The DebriSat project will update and expand upon the information obtained in the 1992 Satellite Orbital Debris Characterization Impact Test (SOCIT), which characterized the breakup of a 1960 s US Navy Transit satellite. There are three phases to this project: the design and fabrication of DebriSat - an engineering model representing a modern, 60-cm/50-kg class LEO satellite; conduction of a laboratory-based hypervelocity impact to catastrophically break up the satellite; and characterization of the properties of breakup fragments down to 2 mm in size. The data obtained, including fragment size, area-to-mass ratio, density, shape, material composition, optical properties, and radar cross-section distributions, will be used to supplement the DoD s and NASA s satellite breakup models to better describe the breakup outcome of a modern satellite

The comparison of grey-scale ultrasonic and clinical features of hepatoblastoma and hepatocellular carcinoma in children: a retrospective study for ten years

<p>Abstract</p> <p>Background</p> <p>Hepatoblastoma (HBL) and hepatocellular carcinoma (HCC) are respectively the first and the second most common pediatric malignant liver tumors. The purpose of this study was to evaluate the combined use of the ultrasound examination and the assessment of the patients' clinical features for differentiating HBL from HCC in children.</p> <p>Methods</p> <p>Thirty cases of the confirmed HBL and 12 cases of the confirmed HCC in children under the age of 15 years were enrolled into our study. They were divided into the HBL group and the HCC group according to the histological types of the tumors. The ultrasonic features and the clinical manifestations of the two groups were retrospectively analyzed, with an emphasis on the following parameters: onset age, gender (male/female) ratio, positive epatitis-B-surface-antigen (HBV), alpha-fetoprotein increase, and echo features including septa, calcification and liquefaction within the tumors.</p> <p>Results</p> <p>Compared with the children with HCC, the children with HBL had a significantly younger onset age (8.2 years vs. 3.9 years, P < 0.001) and a significantly smaller frequency of positive HBV (66.7% vs. 13.3%, P < 0.001). The septa and liquefaction were more frequently found in HBL than in HCC (25/30, 83.3% vs. 2/12, 16.7%, P < 0.001; 17/30, 56.7% vs. 3/12, 25%, P = 0.02). When a combination of the liquefaction, septa, negative HBV and onset age smaller than 5 years was used in the evaluation, the sensitivity was raised to 90%, the accuracy was raised to 88%, and the negative predictive value was raised to 73%.</p> <p>Conclusion</p> <p>Ultrasonic features combined with clinical manifestations are valuable for differentiating HBL from HCC in children.</p

Impact of Coronavirus Disease 2019 Pandemic on the Incidence and Management of Out‐of‐Hospital Cardiac Arrest in Patients Presenting With Acute Myocardial Infarction in England

Background: Studies have reported significant reduction in acute myocardial infarction–related hospitalizations during the coronavirus disease 2019 (COVID‐19) pandemic. However, whether these trends are associated with increased incidence of out‐of‐hospital cardiac arrest (OHCA) in this population is unknown. / Methods and Results: Acute myocardial infarction hospitalizations with OHCA during the COVID‐19 period (February 1–May 14, 2020) from the Myocardial Ischaemia National Audit Project and British Cardiovascular Intervention Society data sets were analyzed. Temporal trends were assessed using Poisson models with equivalent pre–COVID‐19 period (February 1–May 14, 2019) as reference. Acute myocardial infarction hospitalizations during COVID‐19 period were reduced by >50% (n=20 310 versus n=9325). OHCA was more prevalent during the COVID‐19 period compared with the pre–COVID‐19 period (5.6% versus 3.6%), with a 56% increase in the incidence of OHCA (incidence rate ratio, 1.56; 95% CI, 1.39–1.74). Patients experiencing OHCA during COVID‐19 period were likely to be older, likely to be women, likely to be of Asian ethnicity, and more likely to present with ST‐segment–elevation myocardial infarction. The overall rates of invasive coronary angiography (58.4% versus 71.6%; P<0.001) were significantly lower among the OHCA group during COVID‐19 period with increased time to reperfusion (mean, 2.1 versus 1.1 hours; P=0.05) in those with ST‐segment–elevation myocardial infarction. The adjusted in‐hospital mortality probability increased from 27.7% in February 2020 to 35.8% in May 2020 in the COVID‐19 group (P<.001). / Conclusions: In this national cohort of hospitalized patients with acute myocardial infarction, we observed a significant increase in incidence of OHCA during COVID‐19 period paralleled with reduced access to guideline‐recommended care and increased in‐hospital mortality

Managing lifestyle change to reduce coronary risk: a synthesis of qualitative research on peoples’ experiences

Background Coronary heart disease is an incurable condition. The only approach known to slow its progression is healthy lifestyle change and concordance with cardio-protective medicines. Few people fully succeed in these daily activities so potential health improvements are not fully realised. Little is known about peoples’ experiences of managing lifestyle change. The aim of this study was to synthesise qualitative research to explain how participants make lifestyle change after a cardiac event and explore this within the wider illness experience. Methods A qualitative synthesis was conducted drawing upon the principles of meta-ethnography. Qualitative studies were identified through a systematic search of 7 databases using explicit criteria. Key concepts were identified and translated across studies. Findings were discussed and diagrammed during a series of audiotaped meetings. Results The final synthesis is grounded in findings from 27 studies, with over 500 participants (56% male) across 8 countries. All participants experienced a change in their self-identity from what was ‘familiar’ to ‘unfamiliar’. The transition process involved ‘finding new limits and a life worth living’ , ‘finding support for self’ and ‘finding a new normal’. Analyses of these concepts led to the generation of a third order construct, namely an ongoing process of ‘reassessing past, present and future lives’ as participants considered their changed identity. Participants experienced a strong urge to get back to ‘normal’. Support from family and friends could enable or constrain life change and lifestyle changes. Lifestyle change was but one small part of a wider ‘life’ change that occurred. Conclusions The final synthesis presents an interpretation, not evident in the primary studies, of a person-centred model to explain how lifestyle change is situated within ‘wider’ life changes. The magnitude of individual responses to a changed health status varied. Participants experienced distress as their notion of self identity shifted and emotions that reflected the various stages of the grief process were evident in participants’ accounts. The process of self-managing lifestyle took place through experiential learning; the level of engagement with lifestyle change reflected an individual’s unique view of the balance needed to manage ‘realistic change’ whilst leading to a life that was perceived as ‘worth living’. Findings highlight the importance of providing person centred care that aligns with both psychological and physical dimensions of recovery which are inextricably linked

Further investigation of confirmed urinary tract infection (UTI) in children under five years: a systematic review.

Background: Further investigation of confirmed UTI in children aims to prevent renal scarring and future complications. Methods: We conducted a systematic review to determine the most effective approach to the further investigation of confirmed urinary tract infection (UTI) in children under five years of age. Results: 73 studies were included. Many studies had methodological limitations or were poorly reported. Effectiveness of further investigations: One study found that routine imaging did not lead to a reduction in recurrent UTIs or renal scarring. Diagnostic accuracy: The studies do not support the use of less invasive tests such as ultrasound as an alternative to renal scintigraphy, either to rule out infection of the upper urinary tract (LR- = 0.57, 95%CI: 0.47, 0.68) and thus to exclude patients from further investigation or to detect renal scarring (LR+ = 3.5, 95% CI: 2.5, 4.8). None of the tests investigated can accurately predict the development of renal scarring. The available evidence supports the consideration of contrast-enhanced ultrasound techniques for detecting vesico-ureteric reflux (VUR), as an alternative to micturating cystourethrography (MCUG) (LR+ = 14.1, 95% CI: 9.5, 20.8; LR- = 0.20, 95%CI: 0.13, 0.29); these techniques have the advantage of not requiring exposure to ionising radiation. Conclusion: There is no evidence to support the clinical effectiveness of routine investigation of children with confirmed UTI. Primary research on the effectiveness, in terms of improved patient outcome, of testing at all stages in the investigation of confirmed urinary tract infection is urgently required

DebriSat - A Planned Laboratory-Based Satellite Impact Experiment

No abstract availabl