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Mobility and Participation of People With Disabilities Using Mobility Assistive Technologies: Protocol for a Mixed-Methods Study.

BACKGROUND: Many community-dwelling individuals living with a disability use mobility assistive technologies (MATs). MAT devices are generally beneficial for individuals with mobility impairments. However, less is known about the specific factors that may foster or deter mobility and community participation. OBJECTIVE: The purpose of this protocol is to describe the methodology for a study including three main objectives: (1) to understand the places people using MAT go and the things they do, (2) to identify perceived barriers and facilitators as well as users' desired environmental modifica

Is Functional Reconstruction Feasible With Modified Hip Transposition Using a Customized 3D-printed Femoral Prosthesis After Pelvic Tumor Resection? A Preliminary Study.

BACKGROUND: Functional reconstruction after resection of malignant pelvic tumors involving zones I + II ± IV remains a major challenge in orthopaedic oncology. Conventional hip transposition can reduce prosthesis-related complications, but it is often associated with limb shortening and femoral head malrotation. We propose a modified hip transposition technique-femoral lengthening and retroversion hip transposition with a customized three-dimensionally (3D) printed femoral prosthesis-to address deficiencies in limb length, femoral head positioning, and fixation stability, and we evaluate its e

Functional and oncological outcome of acetabular reconstruction for the treatment of metastatic disease.

BACKGROUND: Metastatic disease of the acetabulum can be painful and disabling. Operative intervention is indicated for patients who fail to respond adequately to nonoperative treatment. We evaluated the functional and oncological outcome of acetabular reconstruction after curettage for the treatment of refractory symptomatic acetabular metastases. METHODS: Fifty-five patients with metastatic disease of the acetabulum were treated with operative acetabular reconstruction combined with a total hip replacement. The most common primary tumor was carcinoma of the breast (eighteen patients), follow

What Are the Functional and Surgical Outcomes of Tibial Turnup-plasty for Salvage in Patients With Chronic Lower Extremity Infection?

BACKGROUND: Tibial turnup-plasty is a rarely performed surgical option for large bone defects of the distal or entire femur and can serve as an alternative to hip disarticulation or high above-knee amputation. It entails pedicled transport of the ipsilateral tibia with or without the proximal hindfoot for use as a vascularized autograft. It is rotated 180° in the coronal or sagittal plane to the remaining proximal femur or pelvis, augmenting the functional length of the thigh. Prior reports consist of small case series with heterogeneous surgical techniques. Patient-reported outcome measures a

Acetabular Reconstruction With Femoral Head Autograft After Intraarticular Resection of Periacetabular Tumors is Durable at Short-term Followup.

BACKGROUND: Pelvic reconstruction after periacetabular tumor resection is technically difficult and characterized by a high complication rate. Although endoprosthetic replacement can result in immediate postoperative functional recovery, biologic reconstructions with autograft may provide an enhanced prognosis in patients with long-term survival; however, little has been published regarding this approach. We therefore wished to evaluate whether whole-bulk femoral head autograft that is not contaminated by tumor can be used to reconstruct segmental bone defects after intraarticular resection of

Effects of addition of policosanol to omega-3 fatty acid therapy on the lipid profile of patients with type II hypercholesterolaemia.

BACKGROUND: Policosanol is a mixture of higher aliphatic primary alcohols purified from sugar-cane wax. The mixture has cholesterol-lowering efficacy, its specific effects being to reduce serum total (TC) and low-density lipoprotein cholesterol (LDL-C), and to increase high-density lipoprotein cholesterol (HDL-C). The effects of policosanol on triglycerides (TG) are modest and inconsistent. Omega-3 fatty acids (FA) from fish oil protect against coronary disease, mainly through antiarrhythmic and antiplatelet effects. Omega-3 FA also have lipid-modifying effects, mostly relating to TG reduction

Functional Recovery Following Intensive Upfront Therapy in Multiple Myeloma Patients With Poor Performance Status: A Case Series.

Patients with newly diagnosed multiple myeloma (MM) may present with profound functional impairment due to high disease burden, and an Eastern Cooperative Oncology Group (ECOG) performance status (PS) of 4 is often viewed as a barrier to intensive therapy despite potential reversibility. We report six newly diagnosed, bedbound MM patients (ECOG 4) treated with individualized multi-agent regimens incorporating proteasome inhibitors, immunomodulatory agents, and anti-CD38 monoclonal antibodies when feasible. Advanced features included extensive skeletal disease, renal dysfunction, hyperviscosity

Physical therapy for multiple myeloma patients with severely hindered daily living activities due to bone lesions: a report of two cases.

[Purpose] Physical therapy for patients with multiple myeloma requires appropriate exercise intensity and risk management due to osteolytic lesions. However, the optimal strategy for setting exercise intensity remains unclear. We report cases in which physical therapy was performed using the Borg scale and the Common Terminology Criteria for Adverse Events v4.0 as indicators of improvement in the performance of activities of daily living without causing adverse events. [Participants and Methods] Two patients with multiple myeloma, whose performance status was 4, underwent resistance training o

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… From Day 61, climbing up and down the steps practice and walking practice with two canes (Nordic walking poles) were performed. He could climb up and down the steps with the handrail, and could walk about 15 m with two canes. On Day 77, he was temporarily discharged home for 1 week. … From Day 136, he started walking practice with a 4-legged cane in his right hand and a single-legged cane in his left. He could walk 30 m continuously, but wobbling was observed, so moderate assistance was required. …

Effects of policosanol on borderline to mildly elevated serum total cholesterol levels: a prospective, double-blind, placebo-controlled, parallel-group, comparative study.

BACKGROUND: Hypercholesterolemia is a major risk factor for coronary heart disease. Clinical studies have shown that lowering elevated serum cholesterol levels, particularly low-density lipoprotein cholesterol (LDL-C), is beneficial for patients with borderline to mildly elevated serum total cholesterol (TC) levels (5.0-6.0 mmol/L). Policosanol is a cholesterol-lowering drug made from purified sugar cane wax. The therapeutic range of policosanol is 5 to 20 mg/d. OBJECTIVE: This study investigated the efficacy and tolerability of policosanol 5 mg/d in patients with borderline to mildly elevate

Periacetabular metastases: Proposed extension of the Harrington classification.

OBJECTIVES: To describe the functional outcomes, complications, and reconstruction types in patients with periacetabular metastases and to propose an extension of the Harrington classification. METHODS: Twenty-eight patients (13 males, 15 females) with a mean age of 63.8 ± 15.5 years presented with periacetabular metastases from January 2010 to December 2021. The periacetabular metastases were graded according to Harrington's classification, with four additional categories introduced: A) joint involvement, B) Enneking zone 1 involvement, C) pathological acetabular fracture, and X) none of the

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… The second was a 5-point scale scored as follows. 0 -unable to walk; 1 -able to walk with a walker or two canes; 2 -able to walk with a cane; 3 -impaired walking without assistance; 4 -able to walk normally without assistance. … On the 5-point scale, five patients (17.85 %) were unable to walk, nine (32.14 %) ambulated using a walker or two canes, seven (25.00 %) walked with one cane, six (21.42 %) walked with some impairment but without assistance, and one (3.57 %) walked normally without assistance. …

Оценка понижательного риска при множественном склерозе с использованием результатов, о которых сообщают пациенты, и износимых показателей походок.

Падение людей с множественным склерозом (pwMS) ведет к заболеваемости и расходам. ЦЕЛЬ: Определение клинических параметров, связанных с водопадами. МЕТОДЫ: Eighty-six PCMS завершены обследования осенних осадков, времяd 25-foot Пройдите (T25FW) и анализ движения с помощью устройств Clario Opal. Были разработаны модели логистической регрессии. Результаты: Средний возраст 54.5 годы (дальность 21-73), 62% (В тыс.53) были женщинами. Включена группа 58% с вращением50) и 42% с прогрессивным НР36). Лица, сообщившие о сокращении в прошлом году, были старше (средний возраст) 58 vs. 52.5, р = .03) и имел

Реальная эффективность, стойкость, терпимость и безопасность атумумаба в клинической практике.

АИСЮ: Описание 12-month :: эффективность, стойкость, терпимость и безопасность атумумаба (ОМБ) -- высокоэффективной терапии для борьбы с заболеваниями (ДМТ) для повторного склероза (МС) в реальном мире. & МЕТОДЫ: Электронные медицинские записи пациентов, начинающих OMB с октября 2020 по август 2022 на two Был проведен обзор комплексных центров НР. Демографические показатели и характеристики болезней и 6- и 12-month Были проанализированы клинические, описанные пациентами и радиоологические показатели. РЕЗУЛЬТАТЫ: Всего 175 пациенты начали ОМБ со средним возрастом 44.9 (СД) 10.4) и продолжительн

Artificial intelligence assisted preoperative planning and 3D-printing guiding frame for percutaneous screw reconstruction in periacetabular metastatic cancer patients.

BACKGROUND: The percutaneous screw reconstruction technique, known as the "Tripod Technique," has demonstrated favorable clinical outcomes in the management of metastatic periacetabular lesions, as evidenced by our prior investigations and corroborated by independent studies. Nevertheless, there is a steep learning curve in handling this technique, with possible complications such as intraarticular screw placement. METHODS: Preoperative pelvic CT scans were acquired before surgery and utilized for the guiding frame design. A convolutional neural network model was trained with annotated data t

Operative treatment of displaced intraarticular calcaneal fractures: long-term (10-20 Years) results in 108 fractures using a prognostic CT classification.

OBJECTIVE: The primary purpose of this study was to determine whether the Sanders computed tomography (CT) scan classification was still prognostic for outcome when long-term (10-20 years) radiographic and functional data of patients after open reduction and internal fixation for Sanders type II versus type III displaced intra-articular calcaneal fractures (DIACFs) were compared. The secondary purpose was to assess whether a bone graft or a locked plate was needed to maintain a reduction over time. DESIGN: Prognostic case-control study. SETTING: Level I trauma hospital. PATIENTS: Patients w

Генетические причины непатогенных штаммов Pseudomonas syringae pv. actinidiae в киви-садах.

Бактериальная канцерозная болезнь стала наибольшей угрозой для выращивания и производства киви. Мономорфная подпопуляция Pseudomonas syringae pv. actinidiae biovar 3 (Psa3) отвечает за пандемию по всему миру. В пандемической подпопуляции и других подпопуляциях Psa3, вызывающих эпидемии в Китае, обнаружена разнообразие в патогенности. Однако генетические основы еще не были раскрыты. В данном исследовании 117 изолятов Psa3 были идентифицированы с помощью Psa- и P. Psa3-специфических праймеров и оценены по патогенности. Три изолата G4, G40 и S2 не патогенны для киви и не вызывают гиперчувствитель

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… The 117 Psa3 isolates were identified from the symptomatic canes, leaves, and flowers of kiwifruit with bacterial canker disease as previously described ( Zhao et al., 2013 ). … The mutant exhibited no pathogenicity on kiwifruit canes ( Figure 5B ), and lost the ability to elicit HR in N. benthamina leaves ( Figure 5C ). …

Practice Patterns of Hip Flexion Assist Orthosis Use in Multiple Sclerosis: A Retrospective Community-Based Analysis.

OBJECTIVE: To identify patterns of hip flexion assist orthosis (HFAO) use among ambulatory patients with multiple sclerosis (MS) and to assess factors influencing device adoption and discontinuation. DESIGN: Retrospective chart review. SETTING: Outpatient community physiatry clinic in New Westminster, British Columbia. PARTICIPANTS: Fifty-four ambulatory patients with MS who were previously assessed for HFAO use between November 2017 and October 2023. Patients were 35-92 years old, able to participate in gait evaluation, and had documented physical examinations. Patients with nonambulatory

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… Eighty percent of patients used 1 or more gait aids, including canes, poles, crutches, and walkers. … 6/13 5/3 2/11 5/3 3/3 21/33 Diagnosis Primary progressive 4 2 2 4 3 15 Secondary progressive 5 3 2 3 1 14 Relapsing remitting 4 2 3 0 0 9 Not specified 6 1 6 1 2 16 Time since diagnosis (y), mean 22 20 24 16 17 21 Gait aids/orthoses at the time of HFAO assessment Using a walker 8 1 9 4 1 23 Using a cane …

The impact of multiple sclerosis on wellbeing, productivity, and societal relations.

Multiple sclerosis (MS) is the main cause of nontraumatic neurological disabilities in the population under 50 years of age.To evaluate the most prevalent symptoms in a national sample of people with MS and to analyze their correlation with disease characteristics, demographics, quality of life, employment status, and use of social benefits.Cross-sectional, online, self-reported survey, concerning demographic and clinical data, employment status, and use of social benefits.A total of 466 patients answered the survey. The median age at onset was 30 years, the current age, of 39, and disease dur

Improving functional outcome and quality of life for patients with metastatic lesion of acetabulum undergoing cement augmentation.

There is an increased enthusiasm in treating osteolytic metastatic acetabulum via injecting polymethyl-methacrylate (PMMA) as a bone filler to provide pain relief and potential structural support. The aim of this respective study is to determine the function and quality of life improvement after cement acetabuloplasty.Thirty two patients underwent acetabular cement augmentation between May 2014 and March 2018 were respectively reviewed. Isolated percutaneous acetabuloplasty (PA) was performed in 15 patients (group A) while radiofrequency ablation with PA (RFA-PA) in 12 patients (group B). Toge

Impact of discontinuing 5 years of enzyme replacement treatment in a cohort of 6 adults with hypophosphatasia: A case series.

Asfotase alfa is a human recombinant enzyme replacement therapy for hypophosphatasia. We describe 6 adults who were treated with asfotase alfa for 61-68 months in a clinical trial (NCT01163149), after which asfotase alfa was discontinued for 15-48 months. The patients experienced clinical deterioration and, when treatment was restarted, showed improvement. Patients with hypophosphatasia should be closely monitored if asfotase alfa is stopped as clinical decline is likely. Clinical practice guidelines are needed.

Risk Factors for Poor Outcome after Palliative Surgery for Metastatic Spinal Tumors.

Palliative surgery is performed to improve the quality of life of patients with spinal metastases. However, it is sometimes difficult to achieve the expected results because the patient's condition, and risk factors related to poor outcomes have not been well elucidated. This study aimed to evaluate the functional outcomes and investigate the risk factors for poor outcomes after palliative surgery for spinal metastasis. We retrospectively reviewed the records of 117 consecutive patients who underwent palliative surgery for spinal metastases. Neurological and ambulatory statuses were evaluated