يعرض 1 - 10 نتائج من 408 نتيجة بحث عن '"Mandl, Lisa A."', وقت الاستعلام: 0.88s تنقيح النتائج
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    دورية أكاديمية
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    دورية أكاديمية

    المصدر: CVIR Endovascular ; volume 7, issue 1 ; ISSN 2520-8934

    الوصف: Background Chronic knee pain after total knee arthroplasty (TKA) is a common complication that is difficult to treat. This report aims to highlight the benefit of combining embolotherapy and neurolysis intervention for symptomatic relief of post-TKA pain in a patient with long-standing pain refractory to conservative management. Case presentation A 77-year-old man who had previously undergone left knee arthroplasty has been grappling with worsening knee effusion and debilitating pain, resulting in limited mobility and progressive musculature deconditioning over a 20-year period. Diagnostic arteriography showed marked diffuse periarticular hyperemia around the medial and lateral joint spaces of the left knee, along with capsular distention. The patient initially underwent microsphere embolization to selectively target multiple branches of the genicular arteries, achieving a 50% reduction in pain at the one-month follow-up. Subsequently, the patient underwent image-guided genicular nerve neurolysis, targeting multiple branches of the genicular nerves, which led to further pain reduction (80% compared to the initial presentation or 60% compared to post-embolization) at the one-month follow-up. This improvement facilitated weight-bearing and enabled participation in physical therapy, with sustained pain relief over the 10-month follow-up period. Conclusion The combination of genicular artery embolization and genicular nerve block may be a technically safe and effective option for alleviating chronic pain after total knee arthroplasty.

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    دورية أكاديمية

    المساهمون: Hospital for Special Surgery, National Institute on Aging, Rheumatology Research Foundation

    المصدر: Lupus Science & Medicine ; volume 11, issue 1, page e001008 ; ISSN 2053-8790

    مصطلحات موضوعية: Rheumatology, General Medicine

    الوصف: Objective Frailty and objective hand grip strength (one of the components of the frailty phenotype) are both risk factors for worse health outcomes in SLE. Whether telomere length, an established cellular senescence marker, is a biologic correlate of the frailty phenotype and hand grip strength in patients with SLE is not clear. First, we aimed to evaluate differences in telomere length between frail and non-frail women with SLE and then assessed whether frailty or hand grip strength is differentially associated with telomere length after adjusting for relevant confounders. Methods Women ≥18 years of age with validated SLE enrolled at a single medical centre. Fried frailty status (which includes hand grip strength), clinical characteristics and telomere length were assessed cross-sectionally. Differences between frail and non-frail participants were evaluated using Fisher’s exact or Wilcoxon rank-sum tests. The associations between frailty and hand grip strength and telomere length were determined using linear regression. Results Of the 150 enrolled participants, 131 had sufficient data for determination of frailty classification; 26% were frail with a median age of 45 years. There was a non-significant trend towards shorter telomere length in frail versus non-frail participants (p=0.07). Hand grip strength was significantly associated with telomere length (beta coefficient 0.02, 95% CI 0.004, 0.04), including after adjustment for age, SLE disease activity and organ damage, and comorbidity (beta coefficient 0.02, 95% CI 0.002, 0.04). Conclusions Decreased hand grip strength, but not frailty, was independently associated with shortened telomere length in a cohort of non-elderly women with SLE. Frailty in this middle-aged cohort may be multifactorial rather than strictly a manifestation of accelerated ageing.

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    دورية أكاديمية
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    دورية أكاديمية
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    دورية أكاديمية

    المصدر: Medicine & Science in Sports & Exercise. 52(4)

    الوصف: IntroductionMale youth in the United States commonly participate in gridiron (American) football. There are little data substantiating current popular opinion that it is associated with knee pain or osteoarthritis (OA) later in life. We aimed to evaluate the relationship of football with these outcomes in the Osteoarthritis Initiative (OAI).MethodsThis is a study of male OAI participants with knee x-ray readings, symptom assessments, and completed surveys on lifetime physical activity. The OAI is a multicenter, observational cohort recruited from the community not based on football participation status. A history of exposure to American football was ascertained via self-report. Knee radiographs were scored for Kellgren-Lawrence grade (0-4). Radiographic OA (ROA) was defined as Kellgren-Lawrence ≥ 2 in at least one knee. Frequent knee pain meant at least one knee with frequent knee pain. Symptomatic ROA required at least one knee with both ROA and frequent knee pain.ResultsA total of 1166 men had a mean age of 63.7 (SD, 9.2) yr and body mass index of 28.6 (SD, 4.2) kg·m. Thirty-one percent (365/1166) played football at some point in their lives, 95% of whom participated from ages 12 to 18 yr. The ORs for symptomatic ROA from the lowest to highest football participation were 1.2, 1.5, and 2.2, respectively (P for trend = 0.004). Findings were similar for football from ages 12 to 18 yr and for outcomes of knee pain and ROA.ConclusionThis is the first large epidemiologic study to suggest that football participation, including in the teen years, may be detrimental toward knee health. Prospective studies evaluating football players are warranted.

    وصف الملف: application/pdf

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    دورية أكاديمية
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    دورية أكاديمية
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    دورية أكاديمية

    المساهمون: Clinical and Translational Science Center, Weill Cornell Medical College

    المصدر: ACR Open Rheumatology ; volume 6, issue 3, page 145-154 ; ISSN 2578-5745 2578-5745

    الوصف: Objective Primary care practitioners (PCPs) care for the majority of patients with knee osteoarthritis (KOA). Despite the existing evidence‐based guidelines, PCPs often feel unequipped to evaluate and effectively treat patients with KOA. To address this need, we designed and implemented a free internet‐based program focusing on the diagnosis and treatment of KOA. We assessed whether the program led to improvements in participants’ confidence in their knowledge and skills related to effectively recognizing and caring for patients with or at risk of KOA. Methods We used Caffarella's integrative model to develop a program aligned with the American College of Rheumatology 2019 Guideline for the treatment of KOA. The program incorporated 18 case‐based questions to provide retrieval practice and mastery experiences. We assessed changes in participants’ confidence in their KOA knowledge and skills after program completion. Results Of the first 353 learners completing the program, 53.8% were women, 41.9% had a clinical focus in primary care, and 69.1% were nonphysicians. Overall confidence in KOA knowledge and skills improved after program completion ( P < 0.001; effect size = 1.28, 95% confidence interval 1.12–1.45), with largest improvements among participants with lower pre‐program confidence. A total of 95.8% of participants indicated they would recommend the program to others. Conclusion A free online program focusing on the effective care for patients with KOA attracted a wide range of learners, even though it targeted PCPs. Participants overwhelmingly endorsed it as highly relevant and would recommend it to others. Whether improvements in confidence translate into better patient outcomes is an important area for future research.

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    دورية أكاديمية

    المؤلفون: Mandl, Lisa, Lang, Stefan

    المساهمون: Bayerisches Staatsministerium für Umwelt und Verbraucherschutz, Technische Universität München

    المصدر: PFG – Journal of Photogrammetry, Remote Sensing and Geoinformation Science ; volume 91, issue 3, page 211-231 ; ISSN 2512-2789 2512-2819

    الوصف: Forest ecosystems are shaped by both abiotic and biotic disturbances. Unlike sudden disturbance agents, such as wind, avalanches and fire, bark beetle infestation progresses gradually. By the time infestation is observable by the human eye, trees are already in the final stages of infestation—the red- and grey-attack. In the relevant phase—the green-attack—biochemical and biophysical processes take place, which, however, are not or hardly visible. In this study, we applied a time series analysis based on semantically enriched Sentinel-2 data and spectral vegetation indices (SVIs) to detect early traces of bark beetle infestation in the Berchtesgaden National Park, Germany. Our approach used a stratified and hierarchical hybrid remote sensing image understanding system for pre-selecting candidate pixels, followed by the use of SVIs to confirm or refute the initial selection, heading towards a 'convergence of evidence approach’. Our results revealed that the near-infrared (NIR) and short-wave-infrared (SWIR) parts of the electromagnetic spectrum provided the best separability between pixels classified as healthy and early infested. Referring to vegetation indices, we found that those related to water stress have proven to be most sensitive. Compared to a SVI-only model that did not incorporate the concept of candidate pixels, our approach achieved distinctively higher producer’s accuracy (76% vs. 63%) and user’s accuracy (61% vs. 42%). The temporal accuracy of our method depends on the availability of satellite data and varies up to 3 weeks before or after the first ground-based detection in the field. Nonetheless, our method offers valuable early detection capabilities that can aid in implementing timely interventions to address bark beetle infestations in the early stage.