المؤلفون: Alves, Kristin, Katz, Jeffrey N, Sabatini, Coleen S

المصدر: Journal of Bone and Joint Surgery. 101(4)

مصطلحات موضوعية: Bioengineering, Adolescent, Buttocks, Child, Child, Preschool, Female, Fibrosis, Hip Contracture, Humans, Male, Muscle, Skeletal, Postoperative Complications, Treatment Outcome, Biomedical Engineering, Clinical Sciences, Orthopedics

الوصف: BackgroundThe objective of this study was to analyze the literature regarding the diagnosis, pathogenesis, and prevalence of gluteal fibrosis (GF) and the outcomes of treatment.MethodsWe searched PubMed, Embase, and Cochrane literature databases, from database inception to December 15, 2016. We used the following search terms including variants: "contracture," "fibrosis," "injections," "injections, adverse reactions,' "gluteal," and "hip." All titles and abstracts of potentially relevant studies were scanned to determine whether the subject matter was potentially related to GF, using predefined inclusion and exclusion criteria. If the abstract had subject matter involving GF, the paper was selected for review if full text was available. Only papers including ≥10 subjects who underwent surgical treatment were included in the systematic analysis. Data abstracted included the number of patients, patient age and sex, the type of surgical treatment, the method of outcome measurement, and outcomes and complications.ResultsThe literature search yielded 2,512 titles. Of these, 82 had a focus on GF, with 50 papers meeting the inclusion criteria. Of the 50 papers reviewed, 18 addressed surgical outcomes. The surgical techniques in these papers included open, minimally invasive, and arthroscopic release and radiofrequency ablation. Of 3,733 operatively treated patients in 6 reports who were evaluated on the basis of the criteria of Liu et al., 83% were found to have excellent results. Few papers focused on the incidence, prevalence, and natural history of GF, precluding quantitative synthesis of the evidence in these domains.ConclusionsThis study provided a systematic review of surgical outcomes and a summary of what has been reported on the prevalence, diagnosis, prognosis, and pathogenesis of GF. Although GF has been reported throughout the world, it requires further study to determine the exact etiology, pathogenesis, and appropriate treatment. Surgical outcomes appear satisfactory.Level of evidenceTherapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.

وصف الملف: application/pdf

الوصول الحر: https://escholarship.org/uc/item/08d0d736Test

المؤلفون: Alves, Kristin, Penny, Norgrove, Ekure, John, Olupot, Robert, Kobusingye, Olive, Katz, Jeffrey N, Sabatini, Coleen S

المصدر: BMC Musculoskeletal Disorders. 19(1)

مصطلحات موضوعية: Biomedical and Clinical Sciences, Clinical Sciences, Health Sciences, Clinical Research, Pediatric, Prevention, Buttocks, Child, Child, Preschool, Female, Fibrosis, Humans, Injections, Intramuscular, Male, Paralysis, Prevalence, Retrospective Studies, Rural Health, Uganda, Gluteal fibrosis, Post-injection paralysis, Orthopedics, Clinical sciences, Allied health and rehabilitation science, Sports science and exercise

الوصف: BackgroundThe purpose of this study was to estimate the prevalence of postinjection paralysis (PIP) and gluteal fibrosis (GF) among children treated in a rural Ugandan Hospital.MethodsWe conducted a retrospective cohort study by reviewing the musculoskeletal clinic and community outreach logs for children (age

وصف الملف: application/pdf

الوصول الحر: https://escholarship.org/uc/item/82b3m32wTest

المؤلفون: Alves, Kristin, Godwin, Christine L, Chen, Angela, Akellot, Daniella, Katz, Jeffrey N, Sabatini, Coleen S

المصدر: BMC Health Services Research. 18(1)

مصطلحات موضوعية: Health Services and Systems, Health Sciences, Clinical Research, Prevention, Health Services, 8.1 Organisation and delivery of services, Health and social care services research, Good Health and Well Being, Adult, Attitude of Health Personnel, Buttocks, Child, Delivery of Health Care, Female, Fibrosis, Health Personnel, Humans, Iatrogenic Disease, Injections, Intramuscular, Interviews as Topic, Male, Middle Aged, Motivation, Paralysis, Qualitative Research, Uganda, Gluteal fibrosis, Post-injection paralysis, Injection practices, Safe injection, Pediatric musculoskeletal health, Pediatric orthopaedics, Intramuscular injection, Library and Information Studies, Nursing, Public Health and Health Services, Health Policy & Services, Health services and systems, Public health

الوصف: BackgroundIatrogenic injection injury is a major cause of disability in Ugandan children. Two injuries thought to result from injection of medications into the gluteal region include post-injection paralysis (PIP) and gluteal fibrosis (GF). This study aimed to describe perceptions of local health care workers regarding risk factors, particularly injections, for development of GF and PIP. Specifically, we examine the role of injection practices in the development of these injuries by interviewing a diverse cohort of individuals working in the health sector.MethodsWe conducted a qualitative study in the Kumi and Wakiso Districts of Uganda in November 2017, utilizing 68 key informant interviews with individuals working in healthcare related fields. Interviews were structured utilizing a moderator guide focusing on injection practices, gluteal fibrosis and post-injection paralysis.ResultsWe identified six themes regarding perceptions of the cause of GF and PIP and organized these themes into a theoretical framework. There was a consensus among the individuals working in healthcare that inadequacies of the health care delivery system may lead to inappropriate intramuscular injection practices, which are presumed to contribute to the development of GF and PIP. Poor access to medications and qualified personnel has led to the proliferation of private clinics, which are often staffed by under-trained practitioners. Misaligned economic incentives and a lack of training may also motivate practitioners to administer frequent intramuscular injections, which cost more than oral medications. A lack of regulatory enforcement enables these practices to persist. However, due to limited community awareness, patients often perceive these practitioners as appropriately trained, and the patients frequently prefer injections over alternative treatment modalities.ConclusionThis qualitative study suggests that inappropriate intramuscular injections, may arise from problems in the health care delivery system. To prevent the disability of GF and PIP, it is important to not only address the intramuscular injections practices in Uganda, but also to examine upstream deficits in access, education, and policy enforcement.

وصف الملف: application/pdf

الوصول الحر: https://escholarship.org/uc/item/3nq1t9sfTest

المؤلفون: Alves, Kristin, Penny, Norgrove, Kobusingye, Olive, Olupot, Robert, Katz, Jeffrey N, Sabatini, Coleen S

المصدر: International Orthopaedics. 42(8)

مصطلحات موضوعية: Biomedical and Clinical Sciences, Clinical Sciences, Clinical Research, Pediatric, Brain Disorders, Neurosciences, Rehabilitation, Infection, Musculoskeletal, Adolescent, Child, Child, Preschool, Cohort Studies, Cost of Illness, Cross-Sectional Studies, Female, Humans, Infant, Male, Musculoskeletal Diseases, Prevalence, Retrospective Studies, Surveys and Questionnaires, Uganda, Pediatric musculoskeletal health, Pediatric orthopaedics, Gluteal fibrosis, Post-injection paralysis, MSK burden, Orthopedics, Clinical sciences

الوصف: PurposeThe purpose of this study is to estimate the burden of musculoskeletal disease among children treated in Kumi District, Uganda, to inform training, capacity-building efforts, and resource allocation.MethodsWe conducted a retrospective cohort study by reviewing the musculoskeletal (MSK) clinic and community outreach logs for children (age

وصف الملف: application/pdf

الوصول الحر: https://escholarship.org/uc/item/2253879tTest

المؤلفون: Alves, Kristin M., Lerner, Ariel, Silva, Genevieve S., Katz, Jeffrey N.

المصدر: Journal of Orthopaedic Trauma ; volume 34, issue 4, page 174-179 ; ISSN 0890-5339

الوصف: Objectives: To evaluate the reliability, sensitivity, and specificity of the Squat and Smile (S&S) test, a clinical photographic follow-up, in determination of fracture healing and to assess the extent of continued fracture healing beyond 1-year postoperation. Design: Retrospective review of the Surgical Implant Generation Network (SIGN) database. Setting: The S&S test is utilized in low-resource settings where the SIGN intramedullary nail is used due to unavailability of intraoperative fluoroscopy. Patients/Participants: One hundred fifty patients undergoing fracture fixation utilizing SIGN intramedullary nails with data available at least 1 year (9–16 months) after surgery. Intervention: None. Main Outcome Measures: We extracted clinical data and calculated scores for the S&S photographs and radiographs at the 1-year (9–16 month postoperative) follow-up and last follow-up available beyond that. We analyzed the sensitivity of S&S scoring, using Radiographic Union Scale for Tibia fracture scores as the gold standard for fracture union. Results: Of the 126 patients analyzed, 21% were found to have incomplete healing at 1 year, whereas 17% of the 64 patients with further follow-up past 1 year had incomplete healing. We found that both S&S and radiographic fracture healing scores had good interrater reliability (k = 0.73–0.78 for S&S and 0.94 for radiographs). The S&S test had poor sensitivity (0.11) and specificity (0.85) in determining fracture healing at the 1-year follow-up. Conclusions: The S&S scoring method was reliable but neither sensitive nor specific for determining fracture healing at 1 year. Fractures deemed incompletely healed by radiographic evaluation at 1 year after SIGN implant may still have the potential to heal over time. Level of Evidence: Diagnostic Level IV. See Instructions for Authors for a complete description of levels of evidence.

الإتاحة: https://doi.org/10.1097/bot.0000000000001671Test

المؤلفون: Gartland, Rajshri M., Alves, Kristin, Brasil, Níssia C., Mossanen, Matthew, Mort, Elizabeth, Wright, Cameron D., Lubitz, Carrie C., May, Collin

المصدر: The American Journal of Surgery ; volume 218, issue 1, page 181-191 ; ISSN 0002-9610

مصطلحات موضوعية: General Medicine, Surgery

الإتاحة: https://doi.org/10.1016/j.amjsurg.2018.11.039Test
https://api.elsevier.com/content/article/PII:S0002961018314119?httpAccept=text/xmlTest
https://api.elsevier.com/content/article/PII:S0002961018314119?httpAccept=text/plainTest

المؤلفون: Alves, Kristin, Spencer, Hillard, Barnewolt, Carol E., Waters, Peter M., Bae, Donald S.

المساهمون: American Foundation for Surgery of the Hand

المصدر: The Journal of Hand Surgery ; volume 43, issue 3, page 287.e1-287.e7 ; ISSN 0363-5023

مصطلحات موضوعية: Orthopedics and Sports Medicine, Surgery

الإتاحة: https://doi.org/10.1016/j.jhsa.2017.09.020Test
https://api.elsevier.com/content/article/PII:S0363502317317355?httpAccept=text/xmlTest
https://api.elsevier.com/content/article/PII:S0363502317317355?httpAccept=text/plainTest

المؤلفون: Alves, Kristin, Jupiter, Jesse

المصدر: Techniques in Shoulder & Elbow Surgery ; volume 15, issue 2, page 55-59 ; ISSN 1523-9896

الإتاحة: https://doi.org/10.1097/bte.0000000000000007Test

المؤلفون: Alves, Kristin, Spencer, Hillard T., Waters, Peter M., Bae, Donald S.

المصدر: The Journal of Hand Surgery ; volume 39, issue 9, page e50 ; ISSN 0363-5023

مصطلحات موضوعية: Orthopedics and Sports Medicine, Surgery

الإتاحة: https://doi.org/10.1016/j.jhsa.2014.06.103Test
https://api.elsevier.com/content/article/PII:S0363502314008740?httpAccept=text/xmlTest
https://api.elsevier.com/content/article/PII:S0363502314008740?httpAccept=text/plainTest

المؤلفون: Alves, Kristin, Dahners, Laurence E.

المصدر: Journal of Orthopaedic Trauma ; volume 26, issue 6, page e58-e59 ; ISSN 0890-5339

الإتاحة: https://doi.org/10.1097/bot.0b013e3182323bbeTest