sf 36 scores in degenerative lumbar spine disorders analysis of prospective data from 451 patients

Background When using Health-Related Quality of Life (HRQoL) in assessing outcomes of treatment, normative data for different diagnoses are needed to allow cross-comparisons of existing and future studies. We determined the SF-36 scores in patients with surgical lumbar spine problems.Methods This is a prospective observational study of consecutive surgical patients in one institution. In addition to SF-36 questionnaire responses, local pain, radiating pain, analgesic intake and walking ability were recorded, together with several other demographic variables. 451 patients (50% women) with median age 52 (13–88) years, operated from 1998 through 2002, were included in the study.Results Preoperative SF-36 scores were significantly lower than those derived from previously published material (the general population, nonspecific low back pain (LBP) patients, other samples of non-LBP patients), also with the use of normbased scoring. Sick-leave and worker's compensation seemed to affect perceived Health-Related Q..

reliability of the prospective data collection protocol of the swedish spine register test retest analysis of 119 patients

Background The Swedish Lumbar Spine Register has been collecting patient-based data since 2000, and more than 80% of all spinal units in Sweden are now including their patients. In a few years, it will produce useful clinical information just as arthroplasty registers have, but to permit proper interpretation of data in the future, the reliability of the protocol must be tested.Methods Between January 2000 and March 2003, a sample of 122 patients was asked to fill in the questionnaire twice: 63 preoperatively and 59 postoperatively. Test-retest reliability was calculated with intra-class correlation coefficient (ICC) or weighted kappa when appropriate.Results Test-retest interval varied (range 0–235 days); in the "worst case scenario", the lowest ICC for SF-36 was 0.62 for the postoperative RE. Other values were above 0.70; for non-SF variables, ICC was in the range 0.79–0.89. Kappa values for the ordinal outcomes were high (0.74–0.91).Interpretation When separate reliability analysis was performed accord..

Comorbidity‐related quality of life in anterior cruciate ligament insufficiency: A cross‐sectional study involving 282 candidates for arthroscopic reconstruction

Background and purpose Comorbidity‐adjusted health‐related quality of life (HRQoL) in anterior cruciate ligament insufficiency (ACLI) has not been assessed to date. A cross‐sectional study was conducted to test the hypothesis that HRQoL in ACLI is comorbidity‐related and differs from the Italian norm.Methods 282 chronically ACL‐insufficient candidates for arthroscopic reconstruction with or without meniscal and/or focal chondral lesions were studied. Knee function was evaluated with IKDC form, HRQoL with SF‐36, and associated medical comorbidities with a self‐administered questionnaire allowing calculation of a comorbidity index (CI). Patients were stratified according to CI into subgroup A (CI = 0) and subgroup B (CI > 0). The SF‐36 profiles in the whole sample and in subgroups A and B were compared with the Italian norm.Results Of the 282 patients, 82 had associated comorbidity and 200 did not. Patients with comorbidity were older and had a higher degree of knee laxity than patients without comorbidity...

Cross-cultural adaptation and validation of the Italian version of the Kerlan\u2013Jobe Orthopaedic Clinic Shoulder and Elbow score

Background: The Kerlan\u2013Jobe Orthopaedic Clinic (KJOC) Shoulder and Elbow score is a reliable and sensitive tool to measure the performance of overhead athletes. The purpose of this study was to carry out a cross-cultural adaptation and validation of the KJOC questionnaire in Italian and to assess its reliability, validity, and responsiveness. Materials and methods: Ninety professional athletes with a painful shoulder were included in this study and were assigned to the \u201cinjury group\u201d (n = 32) or the \u201coveruse group\u201d (n = 58); 65 were managed conservatively and 25 were treated by arthroscopic surgery. To assess the reliability of the KJOC score, patients were asked to fill in the questionnaire at baseline and after 2 weeks. To test the construct validity, KJOC scores were compared to those obtained with the Italian version of the Disabilities of the Arm, Shoulder, and Hand (DASH) scale, and with the DASH sports/performing arts module. To test KJOC score responsiveness, the follow-up KJOC scores of the participants treated conservatively were compared to those of the patients treated by arthroscopic surgery. Results: Statistical analysis demonstrated that the KJOC questionnaire is reliable in terms of the single items and the overall score (ICC 0.95\u20130.99); that it has high construct validity (rs =  120.697; p < 0.01); and that it is responsive to clinical differences in shoulder function (p < 0.0001). Conclusions: The Italian version of the KJOC Shoulder and Elbow score performed in a similar way to the English version and demonstrated good validity, reliability, and responsiveness after conservative and surgical treatment. Level of evidence: II

Predictive Factors of Surgical Site Infection in Prosthetic Joint Surgery: A Prospective Study on 760 Arthroplasties

Purpose. The success of total joint arthroplasty (TJA) has led to consistent growth in the use of arthroplasty in progressivelyyounger patients. However, more than 10 percent of patients require revision surgery due to implant failure caused by asepticor septic inflammation. Among the latter, surgical site infection (SSI) represents one of the worst complications of TJA,potentially resulting in the removal of the prosthesis. The aim of our study was to identify potential risk factors for SSIs in apopulation of patients undergoing TJA. Methods. TJA were prospectively recruited at Casa di Cura Santa Maria Maddalenafrom February 2019 to April 2020. Age, sex, major comorbidities, American Society of Anesthesiologists (ASA) class, length ofsurgery, type of surgical suture, total hospital length of stay, and clinical laboratory data were collected. The study populationwas then divided into two groups: Group A, normal postoperative course, and Group B, patients who developed SSI at follow-up (17-25 days). Results. 25/760 (3.3%) patients developed SSIs at follow-up. Clinical and demographic parameters were notdifferent between the two groups. Total leucocyte and neutrophil values at discharge resulted to be significatively higher inGroup B compared to Group A (p = 0:025 and p = 0:016, respectively). Values of 7860/μL for total leucocyte and 5185/μL forneutrophil count at discharge significantly predicted the future development of SSI (AUC 0.623 and AUC 0.641, respectively; p< 0:05) independently from confounding factors (total leukocytes: O:R: = 3, 69 [95% C.I. 1,63-8,32]; neutrophils: O:R: = 3, 98[95% C.I. 1,76-8,97]). Deep SSIs has been diagnosed significantly before superficial SSIs (p = 0,008), with a median advance of9 days. Conclusion. Total leukocytes and neutrophils at discharge seem useful to identify a population at risk for thedevelopment of septic inflammation at the surgical site following TJA. Further studies with larger populations are needed to develop a predictive SSIs risk score that should include those variables

I-PARQUE - PARQUE CIENTÍFICO E TECNOLÓGICO DA UNESC: A PERCEPÇÃO DOS GESTORES PERANTE OS FATORES DE SUCESSO DE UM PARQUE TECNOLÓGICO

INTRODUÇÃO A Universidade do Extremo Sul Catarinense (UNESC) inaugurou oficialmente no ano de 2011 o I-PARQUE – Parque Científico e Tecnológico com o principal objetivo de  fornecer um ambiente inovador para os membros da comunidade empresarial e acadêmica.  Como o I-PARQUE é um projeto bastante recente e inovador, torna-se necessário verificar a direção para onde o parque está caminhando. Desta forma, este trabalho teve como objetivo identificar a percepção dos gestores do I-PARQUE da UNESC perante os fatores de sucesso de um parque científico e tecnológico. Estes fatores de sucesso foram definidos por Zammar et al (2009) com base nos dados do portfólio da Associação Nacional de Entidades Promotoras de Empreendimentos Inovadores (ANPROTEC) de 2008, sendo: foco do parque, setores presentes,  localização, incubação, critérios de admissão, posse do terreno e gestão. METODOLOGIA Em relação aos fins de investigação a pesquisa foi classificada como exploratória e descritiva e quanto aos meios de investigação enquadrou-se como bibliográfica e de campo. Esta pesquisa foi considerada censitária, pois sua população foi composta por todos os gerentes do Parque Científico e Tecnológico da UNESC – I-PARQUE. Para a identificação destes gerentes  realizou-se uma visita ao I-PARQUE no dia 26 de abril de 2012 onde o gestor da Incubadora Tecnológica de Idéias e Negócios identificou cada um dos sete gerentes que participaram da pesquisa. Como instrumento de coleta de dados utilizou-se de  um questionário com abordagem quantitativa, composto por dez perguntas fechadas. As alternativas de cada questão possuíram um grau de importância que variou  de 1 à 5, onde o número 1 era o menos importante e o número 5 o mais importante. O questionário foi aplicado pessoalmente junto aos sete gerentes do I-PARQUE RESULTADOS E DISCUSSÃO A pesquisa identificou que o foco principal do I-PARQUE da UNESC é obter relevância tecnológica, concentrando suas atividades no desenvolvimento e aprimoramento de produtos e processos. Também foi constatado que o foco do parque deve estar direcionado para atender as necessidades da região sul catarinense.  Os setores de atuação elencados como de importante presença foram os setores de Tecnologia Ambiental, Química, Novos Materiais, Tecnologia de Energia e Agro-alimentos/Agricultura. O ponto de maior importância em relação à localização foi à proximidade a uma universidade, estando de acordo com atual localização do I-PARQUE, uma vez que o mesmo está à apenas 4,4 quilômetros da UNESC. A presença da incubadora é primordial para o sucesso do parque e o critério de admissão de empresas na incubadora deve levar em consideração se as empresas são de base tecnológica e se suas atividades estão ligadas ao setor industrial. Referente à concessão de espaço para implantação de empresas no território do parque foi definido como melhor alternativa a locação do terreno para que as empresas possam se instalar na área. Na percepção dos gestores do I-PARQUE a natureza jurídica do mesmo deve ser uma fundação, indo de encontro com a sua gestão, uma vez que pertence a  Fundação Educacional de Criciúma (FUCRI). CONCLUSÃO Percebe-se que o foco do I-PARQUE diverge dos fatores de sucesso para parques tecnológicos elencados por Zammar et al (2009), onde os autores afirmam que um parque tecnológico deve focar em no máximo três setores de atuação para atingir um alto nível de especialização. O resultado da pesquisa demonstrou que a maior parte dos gestores do I-PARQUE prioriza cinco setores de atuação e defende o direcionamento do foco do parque para as necessidades da região. Os resultados relacionados a localização, incubação, critérios de admissão, posse do terreno e gestão estão em total consonância com os estudos de Zammar et al (2009).  Conclui-se que é importante o parque estar localizado próximo a uma universidade, a incubadora e as incubadas são essenciais para o sucesso do parque, pois  permitem que idéias geradas na universidade amadureçam e sejam colocadas em pratica. Também o critério de admissão de empresas deve levar em consideração se as mesmas são de base tecnológica, diferenciando desta forma um parque tecnológico de um distrito industrial e a posse do terreno seja por locação, permitindo que os terrenos cedidos sejam recuperados com facilidade e evitam a possibilidade de especulação imobiliária. A gestão sendo efetuada por uma fundação permite que o parque tenha uma administração ágil e menos burocrática. REFERÊNCIAS ZAMMAR, Gilberto. Infraestrutura para implantação de empresas de base tecnológica: Parque Tecnológico de Ponta Grossa. 2010. 105 f. Dissertação (Mestrado) – Curso de Engenharia de Produção, Universidade Federal Tecnológica do Paraná, Paraná, 2010.   ZAMMAR, Gilberto; KOVALESKI, João Luiz; PILATTI, Luiz Alberto; FRASSON, Antonio Carlos. Parques tecnológicos: fatores importantes na implantação. Disponível em: <http://pg.utfpr.edu.br/dirppg/ppgep/ebook/2009/congressos/internacionais/2009%20-%20adm/55.doc>. Acesso em: 05 mar. 201

Acute Prosthetic Joint Infections with Poor Outcome Caused by Staphylococcus Aureus Strains Producing the Panton-Valentine Leukocidin

The aim of this study was to investigate whether the presence of Staphylococcus aureus (SA) producing the Panton-Valentine leukocidin (PVL) affects the outcome of Prosthetic Joint Infection (PJI). Patients with acute and chronic PJI sustained by SA were prospectively enrolled at the orthopedic unit of "Casa di Cura Santa Maria Maddalena", from January 2019 to October 2021. PJI diagnosis was reached according to the diagnostic criteria of the International Consensus Meeting on PJI of Philadelphia. Synovial fluid obtained via joint aspirations was collected in order to isolate SA. The detection of PVL was performed via real-time quantitative PCR (RT-qPCR). The outcome assessment was performed using the criteria of the Delphi-based International Multidisciplinary Consensus. Twelve cases of PJI caused by SA were included. Nine (75%) cases were acute PJI treated using debridement, antibiotic and implant retention (DAIR); the remaining three (25%) were chronic PJI treated using two-stage (n = 2) and one-stage revision (n = 1), respectively. The SA strains that tested positive for PVL genes were 5/12 (41.6%,). Treatment failure was documented in three cases of acute PJI treated using DAIR, all supported by SA-PVL strains (p < 0.045). The remaining two cases were chronic PJI treated with a revision arthroplasty (one and two stage, respectively), with a 100% eradication rate in a medium follow-up of 24 months. Although a small case series, our study showed a 100% failure rate in acute PJI, probably caused by SA PVL-producing strains treated conservatively (p < 0.04). In this setting, toxin research should guide radical surgical treatment and targeted antibiotic therapy

EULAR recommendations for the non-pharmacological core management of hip and knee osteoarthritis

Introduction: Hip and knee osteoarthritis (OA) are increasingly common with a significant impact on individuals and society. Non-pharmacological treatments are considered essential to reduce pain and improve function and quality of life. EULAR recommendations for the non-pharmacological core management of hip and knee OA were published in 2013. Given the large number of subsequent studies, an update is needed.Methods: The Standardised Operating Procedures for EULAR recommendations were followed. A multidisciplinary Task Force with 25 members representing 14 European countries was established. The Task Force agreed on an updated search strategy of 11 research questions. The systematic literature review encompassed dates from 1 January 2012 to 27 May 2022. Retrieved evidence was discussed, updated recommendations were formulated, and research and educational agendas were developed.Results: The revised recommendations include two overarching principles and eight evidence-based recommendations including (1) an individualised, multicomponent management plan; (2) information, education and self-management; (3) exercise with adequate tailoring of dosage and progression; (4) mode of exercise delivery; (5) maintenance of healthy weight and weight loss; (6) footwear, walking aids and assistive devices; (7) work-related advice and (8) behaviour change techniques to improve lifestyle. The mean level of agreement on the recommendations ranged between 9.2 and 9.8 (0–10 scale, 10=total agreement). The research agenda highlighted areas related to these interventions including adherence, uptake and impact on work.Conclusions: The 2023 updated recommendations were formulated based on research evidence and expert opinion to guide the optimal management of hip and knee OA

Production of He-4 and (4) in Pb-Pb collisions at root(NN)-N-S=2.76 TeV at the LHC

Results on the production of He-4 and (4) nuclei in Pb-Pb collisions at root(NN)-N-S = 2.76 TeV in the rapidity range vertical bar y vertical bar <1, using the ALICE detector, are presented in this paper. The rapidity densities corresponding to 0-10% central events are found to be dN/dy4(He) = (0.8 +/- 0.4 (stat) +/- 0.3 (syst)) x 10(-6) and dN/dy4 = (1.1 +/- 0.4 (stat) +/- 0.2 (syst)) x 10(-6), respectively. This is in agreement with the statistical thermal model expectation assuming the same chemical freeze-out temperature (T-chem = 156 MeV) as for light hadrons. The measured ratio of (4)/He-4 is 1.4 +/- 0.8 (stat) +/- 0.5 (syst). (C) 2018 Published by Elsevier B.V.Peer reviewe

Azimuthal anisotropy of charged jet production in root s(NN)=2.76 TeV Pb-Pb collisions

We present measurements of the azimuthal dependence of charged jet production in central and semi-central root s(NN) = 2.76 TeV Pb-Pb collisions with respect to the second harmonic event plane, quantified as nu(ch)(2) (jet). Jet finding is performed employing the anti-k(T) algorithm with a resolution parameter R = 0.2 using charged tracks from the ALICE tracking system. The contribution of the azimuthal anisotropy of the underlying event is taken into account event-by-event. The remaining (statistical) region-to-region fluctuations are removed on an ensemble basis by unfolding the jet spectra for different event plane orientations independently. Significant non-zero nu(ch)(2) (jet) is observed in semi-central collisions (30-50% centrality) for 20 <p(T)(ch) (jet) <90 GeV/c. The azimuthal dependence of the charged jet production is similar to the dependence observed for jets comprising both charged and neutral fragments, and compatible with measurements of the nu(2) of single charged particles at high p(T). Good agreement between the data and predictions from JEWEL, an event generator simulating parton shower evolution in the presence of a dense QCD medium, is found in semi-central collisions. (C) 2015 CERN for the benefit of the ALICE Collaboration. Published by Elsevier B.V. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).Peer reviewe