The Interaction with Disabled Persons Scale: evidencing construct validity with factor analysis and measurement invariance in Greek-speaking healthcare students.

PURPOSE: To explore the construct validity and reliability of the Greek version of the Interaction with Disabled Persons Scale (IDPS) amongst healthcare students. METHODS: Greek IDPS factors were extracted and confirmed by Analysis of Moment Structures. Measurement invariance for the group of students completing a clinical module with people with disabilities was also evaluated. The scale was distributed twice, 3 weeks apart (test-retest reliability) to sample. Greek IDPS scores amongst students with frequent contact with people with disabilities were compared with those with infrequent contact (discriminant validity). RESULTS: 327 healthcare students (21.25 ± 4.3 years, 118 males) participated. Exploratory factor analysis extracted 6 factors explaining 55.66% of total variance. Confirmatory factor analysis showed a good fit of the model (AGFI = 0.95 > 0.90, RMSEA = 0.07 < 0.08, CFI = 0.95 ≥ 0.90, SRMR = 0.00 < 0.08). An adequate fit for the students completing a clinical practice module was observed. The scale's test-retest reliability and internal consistency were excellent; ICC(2,1)=0.86 (CIs:0.82-0.89) and Cronbach's α = 0.87, respectively. Statistically significant differences between the two student groups were yielded; students with frequent contact with people with disabilities had lower scores (mean difference: -4.5; CI: -6.6 to -2.4), suggesting that they were significantly more comfortable with people with disabilities than the students with infrequent contact. CONCLUSION: The Greek IDPS provided sufficient validity and reliability evidence for evaluating healthcare students' perceptions and attitudes towards people with disabilities.IMPLICATIONS FOR REHABILITATIONThe Greek IDPS demonstrated sufficient validity and reliability evidence to assess the Greek-speaking healthcare students' perceptions and attitudes towards people with disabilitiesCompleting a clinical module working with people with disabilities is not enough to produce adequately positive attitudes in Greek-speaking undergraduate healthcare students. Therefore, faculties need to organize further actions, such as lectures by people with disabilities, students' role play, and discussions or events in co-operation with people with disabilities.

Preseason functional testing in young basketball players: asymmetries and intercorrelations.

[Purpose] The present study aimed to examine the existence and degree of possible asymmetries of functional test performance and their intercorrelations in the lower extremities of young basketball players. [Participants and Methods] Twenty-seven healthy male basketball players (age: 15.52 ± 1.37 years) were examined for the symmetric function of their lower extremities using triple hop for distance tests in the sagittal and frontal plane (medial-lateral), the Y-balance test and a vertical jump test. [Results] Participants exhibited statistically significant side-to-side differences in only the medial triple hop test, as they jumped further on their non-dominant for stability lower limb. No other asymmetries were observed in the rest of the functional tests. Significant correlations were also indicated between the vertical jumptest and the three directions of the triple hop test for both lower limbs. [Conclusion] Our findings proved that young basketball players present a symmetrical picture of functional performance, as revealed by the evaluation of various functional tests. The only significant asymmetric adaptation observed in the medial triple hop test will have to be strengthened by future studies to be implemented in injury prevention programs.

Traumatic pneumorrhachis: etiology, pathomechanism, diagnosis, and treatment.

BACKGROUND CONTEXT: Traumatic pneumorrhachis (PR) is a rare entity, consisting of air within the spinal canal. It can be classified as epidural or subarachnoid, identifying the anatomical space where the air is located, and is associated with different etiologies, pathology, and treatments. PURPOSE: To conduct a systematic review of the scientific literature focused on the etiology, pathomechanism, diagnosis, and treatment of PR, and to report a case of an asymptomatic epidural type. STUDY DESIGN: International medical literature has been reviewed systematically for the term "traumatic pneumorrhachis" and appropriate related subject headings, such as traumatic intraspinal air, traumatic intraspinal pneumocele, traumatic spinal pneumatosis, traumatic spinal emphysema, traumatic aerorachia, traumatic pneumosaccus, and traumatic air myelogram. All cases that were identified were evaluated concerning their etiology, pathomechanism, and possible complications. SAMPLES: Studies that included one of the aforementioned terms in their titles. METHODS: A systematic review was performed to identify, evaluate, and summarize the literature related to the term "traumatic pneumorrhachis" and related headings. Furthermore, we report a rare case of an asymptomatic epidural PR extending to the cervical and thoracic spinal canal. We present the current data regarding the etiology, pathomechanism, diagnosis, and treatment modalities of patients with PR. RESULTS: The literature review included 37 related articles that reported 44 cases of traumatic PR. Only isolated case reports and series of no more than three cases were found. In 21 cases, the air was located in the epidural space, and in 23 cases, it was in the subarachnoid space. Most of the cases were localized to a specific spinal region. However, eight cases extending to more than one spinal region have been reported. CONCLUSIONS: Traumatic PR is an asymptomatic rare clinical entity and often is underdiagnosed. It usually resolves by itself without specific treatment. We stress the significance of this information to trauma specialists, so that they may better differentiate between epidural and subarachnoid PR. This is of great significance because subarachnoid PR is a marker of severe injury. The management of traumatic PR has to be individualized and frequently requires multidisciplinary treatment, involving head, chest, and/or abdomen intervention.

Ninety-degree chevron osteotomy for correction of hallux valgus deformity: clinical data and finite element analysis.

Hallux valgus is a very common foot disorder, with its prevalence estimated at 33% in adult shoe-wearing populations. Conservative management is the initial treatment of choice for this condition, but surgery is sometimes needed. The 60(0) angle Chevron osteotomy is an accepted method for correction of mild to moderate hallux valgus in adults less than 60 years old. A modified 90(0) angle Chevron osteotomy has also been described; this modified technique can confer some advantages compared to the 60(0) angle method, and reported results are good. In the current work we present clinical data from a cohort of fifty-one female patients who had surgery for sixty-two hallux valgus deformities. In addition, in order to get a better physical insight and study the mechanical stresses along the two osteotomies, Finite Element Analysis (FEA) was also conducted. FEA indicated enhanced mechanical bonding with the modified 90(0) Chevron osteotomy, because the compressive stresses that keep the two bone parts together are stronger, and the shearing stresses that tend to slide the two bone parts apart are weaker, compared to the typical 60(0) technique. Follow-up data on our patient cohort show good or excellent long-term clinical results with the modified 90(0) angle technique. These results are consistent with the FEA-based hypothesis that a 90(0) Chevron osteotomy confers certain mechanical advantages compared to the typical 60(0) procedure.

Kümmell' s disease: A rare spine entity in a young adult.

Over 100 years ago, Dr Hermann Kümmell described a rare clinical entity in which patients, after a trivial trauma and an asymptomatic period, developed a progressive vertebral body collapse and a painful kyphosis. We present the case of a 31years old heavy labourer, fitting Kümmell's criteria. The patient referred to us in an incapacitated state, due to persistent back pain. Radiographic examination revealed a body collapse of L1 vertebra. The patient had no previous medical record, other than a prolonged history of transient back pain episodes, related to heavy-weight lifting. Last attack was 1 year before presentation. Through course of time, he had undergone several clinical and radiological evaluations, by different orthopaedists, on different occasions, including the last episode, with no major findings. After an extensive workup, a percutaneous kyphoplasty of the affected vertebra was performed and a biopsy was obtained. The histologic examination of the specimen revealed vertebral osteonecrosis. A triggering pattern of repetitive spinal loading in hyperflexion is, for the first time, being recognized. We conclude that Kümmell's disease, although a rare condition, should be considered in any patient with refractory back pain symptoms. In such patients, vigorous follow-up turns to be of the essence.

Surgical management of cervical spondyloarthropathy in hemodialysis patients.

Dialysis-related spondyloarthropathy is a rare cause of spinal deformity and cervical myelopathy. Optimal management of cervical spine spondyloarthropathy often requires circumferential reconstructive surgery, because affected patients typically have both the anterior column and the facet joints compromised. The occasional presence of noncontiguous or "skip lesions" adds an additional level of complexity to surgical management, because decompression and fusion in an isolated segment of neural compression can worsen spine deformity by applying increased stress to adjacent cervical spine segments. We report two cases of hemodialysis patients who presented with cervical myelopathy and initially had anterior cervical discectomy or corpectomy. Because symptoms recurred due to hardware failure, both patients required posterior spine fusion as well. In retrospect, because of the hardware failure, both of these patients might have benefited from a circumferential (combined anterior and posterior) cervical spine reconstruction as their initial treatment.

An unusual complication of Mitek suture anchor use in primary treatment of flexor digitorum profundus tendon laceration: a case report.

INTRODUCTION: A case of an osteolysis by Mitek anchor-suture is presented. CASE PRESENTATION: A case of index finger's flexor digitorum profundus tendon primary reconstruction with the use of Mitek anchor is presented here. Within a 14 month period, Mitek suture anchor caused local foreign body reaction with osteolysis and ulceration of the palmar skin of the finger while on the other hand tendon's healing was successfully completed. CONCLUSION: Mitek anchor-sutures can cause an aseptic inflammatory reaction which represents a typical biologic response to a foreign body. Concomitant osteolysis can drive to loosening and migration of the implant.

The adult spinal cord injury without radiographic abnormalities syndrome: magnetic resonance imaging and clinical findings in adults with spinal cord injuries having normal radiographs and computed tomography studies.

BACKGROUND: Spinal cord injury without radiographic abnormalities (SCIWORA) is thought to represent mostly a pediatric entity and its incidence in adults is rather underreported. Some authors have also proposed the term spinal cord injury without radiologic evidence of trauma, as more precisely describing the condition of adult SCIWORA in the setting of cervical spondylosis. The purpose of the present study was to evaluate adult patients with cervical spine injuries and radiological-clinical examination discrepancy, and to discuss their characteristics and current management. METHODS: During a 16-year period, 166 patients with a cervical spine injury were admitted in our institution (Level I trauma center). Upper cervical spine injuries (occiput to C2, 54 patients) were treated mainly by a Halo vest, whereas lower cervical spine injuries (C3-T1, 112 patients) were treated surgically either with an anterior, or posterior procedure, or both. RESULTS: Seven of these 166 patients (4.2%) had a radiologic-clinical mismatch, i.e., they presented with frank spinal cord injury with no signs of trauma, and were included in the study. Magnetic resonance imaging was available for 6 of 7 patients, showing intramedullary signal changes in 5 of 6 patients with varying degrees of compression from the disc and/or the ligamentum flavum, whereas the remaining patient had only traumatic herniation of the intervertebral disc and ligamentum flavum bulging. Follow-up period was 6.4 years on average (1-10 years). CONCLUSION: This retrospective chart review provides information on adult patients with cervical spinal cord injuries whose radiographs and computed tomography studies were normal. It furthers reinforces the pathologic background of SCIWORA in an adult population, when evaluated by magnetic resonance imaging. Particularly for patients with cervical spondylosis, special attention should be paid with regard to vascular compromise by predisposing factors such as smoking or vascular disease, since they probably contribute in the development of SCIWORA.

Assessing sexual function in obese women preparing for bariatric surgery.

BACKGROUND: Obesity has become a modern epidemic, increasingly affecting the general population worldwide. Obese people are vulnerable to a variety of co-morbidities, including cardiovascular and pulmonary disease, osteoarthritis, diabetes, cancer and psychiatric conditions, that not only diminish life expectancy but also impair quality of life. Research has shown that obesity is further linked to sexual dysfunction, although relevant studies are limited and further investigation is needed. METHODS: We assessed the sexual function of 60 obese women scheduled to undergo bariatric surgery and 50 healthy controls matched by age, education and marital status. All participants were administered the Female Sexual Function Index (FSFI). Additionally, participants completed the Hospital Anxiety and Depression Scale (HADS). RESULTS: Obese women reported significant impairment on most domains of sexual function, including sexual desire, arousal, lubrication, orgasm, and satisfaction, compared to healthy controls. The observed sexual impairment was associated with BMI but was not entirely attributed to the presence of anxiety or depression. CONCLUSION: Obese women complain of significant sexual impairment. Obesity-related sexual dysfunction appears to be a complex condition linked to a range of social, psychological and biological factors. Clinicians are encouraged to evaluate routinely sexual function in this patient population in order to detect those who are in need of intervention.

Sexual function in females with severe cervical spinal cord injuries: a controlled study with the Female Sexual Function Index.

The objective of this study was to identify the sexual adjustment of females with severe cervical spinal cord injuries (SCI) using the Female Sexual Function Index (FSFI). The 19-item questionnaire of the FSFI concerns sexual function and satisfaction in sex life. This study, conducted by the Orthopaedic and Psychiatry Departments of Patras University, used a sample of a series of 39 consecutive female patients with severe traumatic SCI. We compared these female patients with an age-economic-educational level- and marital status-matched control group of the general population. Sexual activity was lower among females with SCI, but the desire, the emotional quality of sex life and overall sexual satisfaction did not differ from the controls. These results demonstrate that sexual life in females with SCI remains almost unaffected.