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10.
Br J Hosp Med (Lond) ; 82(10): 1-7, 2021 Oct 02.
Article in English | MEDLINE | ID: mdl-34726943

ABSTRACT

The Newborn and Infant Physical Examination screening is a national screening programme which aims to identify infants with congenital abnormalities to minimise the risk of long-term complications. It involves a top to toe examination with special focus on the heart, eyes, testes and hips. The hip component of the Newborn and Infant Physical Examination screen aims to pick up infants with developmental dysplasia of the hips and refer them for appropriate treatment in a timely manner. Guidelines for the hip section of have recently changed. This article reviews these changes, the timings of the follow up and investigations, and the diagnosis and management of developmental dysplasia of the hips.


Subject(s)
Hip Dislocation, Congenital , Hip Dislocation, Congenital/diagnosis , Hip Dislocation, Congenital/epidemiology , Hip Dislocation, Congenital/therapy , Humans , Infant , Infant, Newborn , Mass Screening , Physical Examination , Ultrasonography , United Kingdom/epidemiology
11.
J Knee Surg ; 34(14): 1603-1608, 2021 Dec.
Article in English | MEDLINE | ID: mdl-32450601

ABSTRACT

Unicompartmental knee arthroplasty (UKA) is a recognized procedure for treatment of medial compartment osteoarthritis. Patellofemoral (PF) joint degeneration is widely considered to be a contraindication to medial compartment UKA. We examined the validity of this preconception using information gathered prospectively on 147 consecutive patients who underwent the Repicci II UKA for medial compartment osteoarthritis between July 1999 and September 2000 by the same surgeon. The status of the PF joint was assessed intraoperatively in all patients, and accordingly patients were divided into two groups. Among them, 69 had associated PF osteoarthritis (group A), while 78 patients had a normal PF compartment (group B). Variables measured included the International Knee Society (IKS) score, limb alignment, and range of motion. Radiographs, demographic data, length of hospital stay, perioperative complications were also measured. All subsequent surgery and survivorship at 10 years were recorded. The mean follow-up was 9.4 years (range: 5-10.7 years) and results of the two groups were compared. We found no significant differences in terms of IKS scores, alignment, and flexion between the two groups. However, measured extension was significantly increased postoperatively in those patients with minimal or no PF joint degenerative disease (p < 0.05).


Subject(s)
Arthroplasty, Replacement, Knee , Knee Prosthesis , Osteoarthritis, Knee , Humans , Knee Joint/diagnostic imaging , Knee Joint/surgery , Osteoarthritis, Knee/diagnostic imaging , Osteoarthritis, Knee/surgery , Prospective Studies , Treatment Outcome
13.
Circ Cardiovasc Imaging ; 9(3): e003900, 2016 Mar.
Article in English | MEDLINE | ID: mdl-26926269

ABSTRACT

BACKGROUND: Hybrid positron emission tomography and magnetic resonance allows the advantages of magnetic resonance in tissue characterizing the myocardium to be combined with the unique metabolic insights of positron emission tomography. We hypothesized that the area of reduced myocardial glucose uptake would closely match the area at risk delineated by T2 mapping in ST-segment-elevation myocardial infarction patients. METHODS AND RESULTS: Hybrid positron emission tomography and magnetic resonance using (18)F-fluorodeoxyglucose (FDG) for glucose uptake was performed in 21 ST-segment-elevation myocardial infarction patients at a median of 5 days. Follow-up scans were performed in a subset of patients 12 months later. The area of reduced FDG uptake was significantly larger than the infarct size quantified by late gadolinium enhancement (37.2±11.6% versus 22.3±11.7%; P<0.001) and closely matched the area at risk by T2 mapping (37.2±11.6% versus 36.3±12.2%; P=0.10, R=0.98, bias 0.9±4.4%). On the follow-up scans, the area of reduced FDG uptake was significantly smaller in size when compared with the acute scans (19.5 [6.3%-31.8%] versus 44.0 [21.3%-55.3%]; P=0.002) and closely correlated with the areas of late gadolinium enhancement (R 0.98) with a small bias of 2.0±5.6%. An FDG uptake of ≥45% on the acute scans could predict viable myocardium on the follow-up scan. Both transmural extent of late gadolinium enhancement and FDG uptake on the acute scan performed equally well to predict segmental wall motion recovery. CONCLUSIONS: Hybrid positron emission tomography and magnetic resonance in the reperfused ST-segment-elevation myocardial infarction patients showed reduced myocardial glucose uptake within the area at risk and closely matched the area at risk delineated by T2 mapping. FDG uptake, as well as transmural extent of late gadolinium enhancement, acutely can identify viable myocardial segments.


Subject(s)
Coronary Circulation , Magnetic Resonance Imaging, Cine , Multimodal Imaging/methods , Myocardial Infarction/diagnosis , Myocardial Infarction/therapy , Myocardial Perfusion Imaging/methods , Myocardium/pathology , Percutaneous Coronary Intervention , Positron-Emission Tomography , Aged , Contrast Media , Female , Fluorodeoxyglucose F18/metabolism , Heterocyclic Compounds , Humans , Image Interpretation, Computer-Assisted , Male , Middle Aged , Myocardial Infarction/diagnostic imaging , Myocardial Infarction/metabolism , Myocardial Infarction/pathology , Myocardial Infarction/physiopathology , Myocardium/metabolism , Organometallic Compounds , Predictive Value of Tests , Radiopharmaceuticals/metabolism , Recovery of Function , Time Factors , Tissue Survival , Treatment Outcome
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